Abstract

Aim: The aim of the present analysis was to compare cardiovascular disease risk factors in patients from different countries in Europe, using baseline data from the Liraglutide Effect and Action in Diabetes: Evaluation of cardiovascular outcome Results (LEADER) trial. Methods: Baseline characteristics and treatments were compared between the subgroup of patients with established cardiovascular disease included in this study from the Eastern European Union (EEU), Western European Union (WEU), and Russia and Serbia (Ru/Se). Results: Glycaemic control was similar in the EEU and WEU, and poorest in Ru/Se, although WEU patients were older and had longer diabetes duration. Systolic blood pressure was lowest in Ru/Se, whereas diastolic blood pressure was lowest in the WEU. Control of dyslipidaemia was best in the WEU, and worst in Ru/Se. The percentage of patients meeting all three targets for cardiovascular risk factors (HbA1c: ≤ 64 mmol/mol [8.0%], blood pressure: <140/<90 mmHg and low-density lipoprotein [LDL]-cholesterol: 1.8 mmol/L [70 mg/dL]) was 9.7%, 6.4% and 3.2% in the WEU, EEU and Ru/Se, respectively. Metformin and sulphonylurea treatment was more frequent in the EEU than WEU and Ru/Se. Insulin, in turn, was used less frequently in the EEU than WEU and Ru/Se. The use of newer drugs was small and differences could not be subjected to statistical analyses. Statins were used most frequently in WEU countries and least frequently in Ru/Se. Conclusion: The high cardiovascular risk patients in the WEU were older and had longer diabetes duration, when compared with EEU and Ru/Se. Despite this, they had a lower body mass index (BMI), similar blood pressure and better lipid control. Although the differences were small, the percentage of patients meeting all three treatment targets was low across all regions studied.

Highlights

  • Western European Union (EU) participants had a longer history of diabetes and lower body mass index (BMI) than the other regions

  • diastolic blood pressure (DBP) levels were lowest in Western EU participants (77.4 ± 10.5 compared to 81.3 ± 9.5 and 82.3 ± 8.1 mmHg for Eastern EU and Russia/Serbia, respectively) (p

  • Control of dyslipidaemia was most rigorous in the Western EU and poorest in Russia/Serbia (LDL: 3.0 ± 1.0 mmol/L; high-density lipoprotein (HDL): 1.18 ± 0.31 mmol/L; triglycerides: 2.5 ± 1.9 mmol/L)

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Summary

Introduction

There are, many regional and national differences in the incidence and prevalence of diabetes and associated complications. These differences may be partially explained by varying prevalence of obesity, differences in age distribution and different health service expenditures. Major political, social and economic changes in these countries began in 1989, increasing the living standards of these populations. These changes led the gross domestic product in Poland to increase by 382% between

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