A half ounce of prevention ...

Abstract

This editorial refers to ‘Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe. The EURIKA study’, by J.R. Banegas et al. doi:10.1093/eurheartj/ehr080 An ounce of prevention is worth a pound of cure. Enormous progress has been made in diagnosis and management of cardiovascular disease, resulting in improved life expectancy in most countries in Europe. Similarly we know that the onset of atherosclerosis and its sequellae (angina, myocardial infarction, stroke, heart failure, and sudden death) can be prevented, or rather deferred, by optimal management of hypertension and diabetes, by avoidance of smoking and overweight, and by lowering of LDL-cholesterol through diet or medication with statins. However, this is easily said but difficult to achieve in practice. The EURIKA study1 demonstrates again that many subjects known to be at increased risk for development of cardiovascular disease have an undesirable lifestyle and risk factors that remain uncontrolled. EURIKA analysed 7641 subjects with known risk factors from 12 European countries, ∼650 subjects from each country, sampled using a database of general practitioners. Of these ∼44% were obese, 21% were smokers, 27% had diabetes, 73% had hypertension, and 58% were known to have elevated lipid concentrations.1 In spite of medical treatment, diabetes was not adequately controlled since glycated haemoglobin (HbA1c) remained >6.5% in 73% of the patients. Blood pressure was not controlled in 61% of treated …