Increase In CV Risk Factors Heralds Epidemic Of Cardiovascular Disease

Main Category: Cardiovascular / Cardiology
Also Included In: Heart Disease
Article Date: 15 Sep 2009 - 23:00 PDT

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Commenting on a study published today in Circulation (1), showing after two decades of improvement, the percentage of Americans without risk factors for heart disease was falling, Professor Guy De Backer, from the Division of Cardiology at the University of Gent, Belgium, said that with the rising levels of obesity in the US such findings could hardly be considered surprising.

"Over the next few years it's likely that this observed decline in the proportion of people with low cardiovascular risks will translate into increased cardiovascular disease," said Professor De Backer, a former chair of the European Society of Cardiology (ESC) Joint Prevention Committee. "This paper should act as a wake-up call in Europe as well as the US, since overall European risk factors are not so different. While obesity may be higher in the US, Europe has been less successful in reducing smoking and cutting blood pressure."

Indeed, the EuroAspire survey(2), which reviewed risk factors in patients with established coronary heart disease from 22 European countries, found that only 6 % of men and 4 % women were achieving lifestyle, risk factor and therapeutic targets for prevention.

"Health surveillance is essential for the development of good health policy. We need to know exactly what are the problems we are facing to determine the best ways of counteracting them," said Professor De Backer.

Commenting last week at the EuroHeart Conference (Brussels, Belgium Thursday September 10, 2009), a meeting organised by the European Heart Network and the ESC as part of Work Package 5 of the EuroHeart Project, Professor De Backer said that it is a major issue that no overall surveillance initiatives have been put in place in Europe to review changing trends in cardiovascular risk factors for the general European population."While different countries may be running their own initiatives there needs to be a standardised approach to allow meaningful comparisons, and enable countries to learn from each other" said Professor De Backer, adding that the European Union needs to be taking a greater lead in advising its member states on cardiovascular disease prevention.

Professor Torben Jorgensen, an ESC Spokesperson on prevention from the Research Centre for Prevention (Glostrup. Denmark), said that the study by Earl S Ford and colleagues in Circulation indicated that the current strategy of targeting individuals at high risk of heart disease for prevention was not working.

"Evidence suggests that you can get people to change their attitudes for short periods, but that this is not long enough to prevent obesity, diabetes and high blood pressure," he said. "Instead society as a whole needs to foster a general environment which encourages healthy eating and physical activity, including adaptations to towns and cities that favour pedestrians and cyclists. Such initiatives should start in schools and the work place, and will require good collaboration between politicians and doctors for success."

Evidence, he added, shows that just small life-style changes made in society as a whole have a tremendous impact on obesity and diabetes. "Our present unlucky situation is due to changes in society that have occurred over the past decades - so future "medicine" must look into improving society's infrastructure," he said.

References

1. Less than 10 percent of Americans have low risk for heart disease, Earl S. Ford, with co-authors Chaoyang Li, Guixiang Zhao, William S. Pearson and Simon Capewell, Circulation, 2009

2. Kotseva K, Wood D, De Backer G, et al. EUROASPIRE III: A survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from twenty-two European countries. Eur J Cardiovasc Prev Rehabil 2009; doi: 10.1097/HJR.0b013e3283294b1d

3. EuroHeart project: The EuroHeart project is a joint initiative of the European Society of Cardiology (ESC) and the European Heart Network, set up to address the significant burden of CVD in Europe and to determine specific areas of intervention to contribute to preventing avoidable deaths and disability.

The project, which involves partners in 21 countries and receives funding from the European Commission Public Health Programme, has five major objectives: 1. Mobilise broad support for cardiovascular health (CVH) promotion and cardiovascular disease prevention with a view to achieving stronger cross sector cooperation (Work Package 4, 2. Map and analyze national plans, policies and measures impacting on cardiovascular health promotion and cardiovascular disease prevention. (Work Package 5), 3. Investigate issues concerning CVD in women (Work Package 6), 4. Improve prevention practices at primary care level (Work Package 7), 5. Implement and adapt European guidelines on CVD prevention to national situations (Work Package 8).

Source
European Society of Cardiology