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EUROASPIRE IV:Where do we stand after EUROASPIRE I, II and III?
Kornelia Kotsevaon behalf of the EUROASPIRE Investigators
National Heart and Lung Institute
Imperial College London
Declaration of interest: Research contracts
European guidelines and surveys oncardiovascular disease prevention
1994 First Joint Task Force Recommendations
1994 Joint European Societies Implementation Group
on Coronary Prevention
1995-96 EUROASPIRE I
1998 Second Joint Task Force Recommendations
1999-2000 EUROASPIRE II
2000 Joint European Societies CVD Prevention Committe
2003 Third Joint Task Force Recommendations
Joint European Societies CVD Prevention Committe
2006-2007-06 EUROASPIRE III
2007 Fourth Joint Task Force Recommendations
2012 Fifth Joint Task Force Recommendations
2012 -13 EUROASPIRE IV - EUROPEAN SURVEY OF CVD PREVENTION AND DIABETES
Euroaspire IVParticipating countries
Finland
Czech RepublicFrance
Germany
Netherlands
SloveniaSpain
Belgium
Ireland
UK
Greece
Poland
Latvia
Lithuania
Romania
Russia
Croatia
Bulgaria
Cyprus
Turkey
Serbia Bosnia
Herzegovina
Ukraine
Sweden
Euroaspire IVThe essential components
Identifies risk factors in coronary patients
Describes their management through life style
advice and the use of drug therapy
Presents an objective assessment of the clinical
implementation of current evidence based knowledge
The survey
Euroaspire IV
Study population
Consecutive patients, men and women < 80 yrs,hospitalised at least 6 months and at most 3 years priorto the interview1. Elective or emergency CABG
2. Elective or emergency PCI
3. Acute Myocardial Infarction (AMI) (ST-elevation or non-ST elevation MI)
4. Acute Myocardial Ischaemia (Ischaemia) but NO evidence of AMI (Troponin negative)
Euroaspire IV
Outcome measures
Proportions of coronary patients achieving the European lifestyle, risk factor and therapeutic targets for cardiovascular disease prevention defined in the Joint European Societies Guidelines on CVD prevention
Euroaspire IV
Data collection
Trained research assistants
Retrospective identification of patients (not less
than 6 months and not more than 3 years prior
to the expected date of interview)
Review of medical notes
Interview and examination
Euroaspire IV
Recorded in all patients
Height, weight (SECA height measure & weighing scales)
Waist circumference (Metal tape measures)
Blood pressure (Omron M6)
Breath CO (Bedfont Micro+)
Fasting venous blood sample for serum total cholesterol, HDL-
cholesterol, triglycerides, HbA1c and creatinine
HbA1c, Fasting glucose, OGTT (HemoCue®)
Urine albumin/ creatinine ratio
EUROASPIRE IV
• 24 countries
• 76 centres
• 13,586 patients with CHD
• 7998 interviews
Lifestyle
• No smoking
• Healthy food choices
• Physical activity: 30 min of moderate activity a day
• BMI <25 kg/m2 and avoidance of central obesity
Speaker
8%
8%
10%
11%
12%
12%
12%
14%
14%
16%
16%
17%
17%
18%
18%
18%
18%
19%
20%
20%
23%
25%
26%
28%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Finland Belgium Slovenia
Romania Spain
Germany
Latvia
Sweden
Ukraine
United Kingdom Netherlands
Ireland Bosnia Herzegovina
Croatia Czech Republic
Lithuania
Serbia
Bulgaria
Greece
Poland Russian Federation
France Turkey
Cyprus
Prevalence of smoking*
* Self-reported smoking or CO in breath > 10 ppm
All patients: 16.0%
Men 17.6% , Women 11.1%
27%
30%
34%
38%
39%
44%
47%
47%
48%
50%
50%
50%
52%
52%
52%
52%
53%
53%
53%
55%
60%
61%
65%
71%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Spain Romania
Bosnia Herzegovina
Serbia Belgium
Slovenia
Cyprus
Ukraine
Latvia
Ireland Netherlands
Sweden Poland
Czech Republic Germany
Lithuania
Greece
Turkey
Finland
Croatia Bulgaria
United Kingdom Russian Federation
France
Prevalence of persistent smoking*
All patients: 48.6%
Men 49.3% , Women 45.4%
* Prevalence of smoking (self-reported smoking or CO in breath > 10 ppm) among patients smoking in the month prior to the index event
26%
27%
27%
29%
30%
31%
33%
36%
36%
37%
37%
37%
38%
38%
39%
40%
41%
42%
42%
43%
45%
46%
49%
51%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Serbia Bosnia Herzegovina
Sweden
Netherlands Belgium
Spain
Greece
United Kingdom
France
Germany Croatia
Poland Finland
Ukraine Ireland
Latvia
Turkey
Cyprus
Czech Republic
Bulgaria Lithuania
Romania Slovenia
Russian Federation
All patients: 37.6%
Men 35.6% , Women 43.8%
* Body Mass Index ≥ 30 kg/m²
Prevalence of obesity*
47%
48%
48%
48%
51%
51%
53%
53%
54%
55%
55%
56%
57%
58%
58%
60%
61%
62%
63%
63%
69%
72%
72%
73%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Bosnia Herzegovina Belgium Poland
Turkey Spain
Ukraine
Latvia
Netherlands
France
Serbia Ireland
Sweden Bulgaria
United Kingdom Croatia
Greece
Lithuania
Finland
Germany
Russian Federation Czech Republic
Slovenia Romania
Cyprus
All patients: 58.2%
Men 52.8% , Women 75.2%
Prevalence of central obesity*
* Waist circumference ≥ 102 cm for men or ≥ 88 cm for women
86%
81%
79%
75%
62%
69%
65%
71%
68%
65%
68%
74%
72%
71%
64%
68%
61%
58%
56%
62%
54%
44%
20%
38%
9%
11%
8%
12%
24%
16%
19%
12%
14%
17%
14%
6%
7%
7%
12%
7%
14%
15%
15%
9%
13%
14%
31%
12%
5%
9%
13%
13%
14%
15%
16%
18%
19%
19%
19%
21%
22%
22%
24%
25%
26%
27%
29%
29%
33%
42%
49%
50%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Turkey
Lithuania
Ireland
Slovenia
Russian Federation
Spain
Romania
United Kingdom
Sweden
Greece
Serbia
Bulgaria
Czech Republic
Latvia
Ukraine
Cyprus
Belgium
Croatia
France
Poland
Finland
Netherlands
Bosnia Herzegovina
Germany
Low Moderate High
Physical activity: IPAQ classification
All patients: 62.0% 13.5% 24.5%
• Blood pressure < 130/80 mmHg if feasible
• Total cholesterol <4.5 mmol/L (175 mg/dL); <4.0 mmol/L (155 mg/dL) if feasible
• LDL-C <2.5 mmol/L (100 mg/dL); <2.0 mmol/L (80 mg/dL) if feasible
• Diabetes mellitus: fasting blood glucose <6 mmol/L (110 mg/dL) and HbA1c < 6.5% if feasible
Medical Risk factors
European Guidelines on CVD Prevention- JES 2007
• Blood pressure < 140/90 mmHg, <140/80 mmHg in patients with diabetes
• LDL-C <1.8 mmol/L (70 mg/dL) or ≥50% reduction
• Diabetes mellitus: HbA1c < 7.0% (53 mmol/mol)
Medical Risk factors
European Guidelines on CVD Prevention- JES 2012
48%
49%
49%
53%
58%
58%
61%
62%
63%
65%
66%
67%
67%
70%
73%
73%
73%
73%
75%
76%
77%
81%
82%
90%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Romania
Ireland
Russian Federation
Greece
Finland
Bulgaria
Belgium
Sweden
Serbia
United Kingdom
Spain
France
Turkey
Germany
Ukraine
Croatia
Poland
Slovenia
Czech Republic
Netherlands
Lithuania
Latvia
Cyprus
Bosnia Herzegovina
JES 2012
BP ≥140/90 mmHg (≥140/80 in
patients with diabetes)
All patients: 43%
Men 42% , Women 44%
Blood pressure ≥ 130/80 mmHg
JES 2007:
BP ≥130/80 mmHg
All patients: 67%
Men 67% , Women 68%
JES 2007:
BP <130/80 mmHg
All patients: 29%
Men 29% , Women 30%
Therapeutic control of blood pressure *
* BP < 130/80 mmHg among patients using antihypertensive drugs
19%
20%
25%
27%
31%
32%
33%
34%
34%
38%
38%
39%
39%
40%
43%
44%
53%
54%
55%
58%
60%
61%
65%
66%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Spain
Finland
Slovenia
Ireland
United Kingdom
France
Belgium
Latvia
Sweden
Romania
Cyprus
Czech Republic
Poland
Netherlands
Croatia
Greece
Germany
Turkey
Serbia
Bosnia Herzegovina
Russian Federation
Ukraine
Bulgaria
Lithuania
LDL-C ≥ 2.5 mmol/L
All patients: 42%
Men 40% , Women 49%
LDL cholesterol ≥ 2.5 mmol/L
LDL-C ≥ 2.0 mmol/L
All patients: 69%
Men 67% , Women 75%
59%
66%
67%
69%
71%
71%
74%
77%
79%
79%
79%
79%
80%
81%
84%
86%
87%
88%
89%
89%
89%
92%
93%
96%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Spain
Ireland
Finland
Slovenia
Latvia
United Kingdom
France
Czech Republic
Poland
Croatia
Netherlands
Cyprus
Romania
Sweden
Greece
Belgium
Russian Federation
Ukraine
Bosnia Herzegovina
Serbia
Germany
Turkey
Bulgaria
Lithuania
All patients: 85%
Men 79% , Women 84%
LDL cholesterol ≥ 1.8 mmol/L
42%
44%
45%
46%
47%
50%
52%
53%
57%
61%
62%
63%
64%
65%
66%
67%
68%
69%
70%
75%
75%
79%
80%
84%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Lithuania
Bulgaria
Ukraine
Bosnia Herzegovina
Serbia
Russian Federation
Germany
Turkey
Greece
Croatia
Cyprus
Netherlands
Czech Republic
Poland
Romania
Belgium
Latvia
France
Sweden
Ireland
United Kingdom
Slovenia
Spain
Finland
LDL-C <2.5 mmol/L
All patients: 63%
Men 65% , Women 55%
LDL cholesterol < 2.5 mmol/L in patients on lipid-lowering medication
LDL-C <2.0 mmol/L
All patients: 34%
Men 36% , Women 28%
5%
8%
10%
12%
12%
14%
14%
15%
16%
16%
20%
21%
21%
22%
22%
23%
23%
27%
31%
32%
33%
34%
35%
41%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Lithuania
Bulgaria
Turkey
Germany
Serbia
Bosnia Herzegovina
Belgium
Ukraine
Greece
Russian Federation
Sweden
Netherlands
Cyprus
Croatia
Romania
Poland
Czech Republic
France
Latvia
United Kingdom
Finland
Slovenia
Ireland
Spain
All patients: 21%
Men 22% , Women 17%
LDL cholesterol < 1.8 mmol/L in patients on lipid-lowering medication
15%
19%
20%
20%
21%
21%
23%
23%
25%
25%
26%
26%
28%
31%
31%
32%
33%
33%
33%
35%
36%
36%
37%
41%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Ireland Lithuania
Netherlands
Russian Federation Latvia
Bosnia Herzegovina
Ukraine
Belgium
Finland
Germany Serbia
Croatia Sweden
Bulgaria Poland
France
United Kingdom
Romania
Spain
Cyprus Czech Republic
Turkey Slovenia
Greece
All patients: 27%
Men 26% , Women 31%
Prevalence of self-reported diabetes
4%
5%
5%
6%
7%
9%
10%
10%
11%
12%
12%
15%
15%
16%
16%
16%
17%
18%
19%
19%
19%
19%
21%
23%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Sweden Finland Turkey
United Kingdom Russian Federation
Romania
France
Bulgaria
Belgium
Latvia Slovenia
Netherlands Croatia
Serbia Czech Republic
Poland
Ireland
Lithuania
Germany
Spain Ukraine
Bosnia Herzegovina Greece
Cyprus
All patients: 13%
Men 13% , Women 12%
Fasting glucose ≥ 7 mmol/L in patients without diabetes
27%
28%
30%
30%
32%
32%
34%
38%
38%
38%
39%
39%
39%
39%
40%
40%
41%
43%
44%
45%
46%
47%
55%
55%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Russian Federation Finland Ireland
Latvia Belgium
Sweden
Lithuania
United Kingdom
Serbia
Ukraine Bulgaria
Croatia Bosnia Herzegovina
Romania France
Germany
Turkey
Netherlands
Poland
Slovenia Spain
Czech Republic Greece
Cyprus
All patients: 38%
Men 37% , Women 40%
Prevalence of diabetes mellitus*
* Self-reported diabetes or fasting glucose ≥ 7 mmol/L
7%
8%
9%
10%
10%
10%
12%
12%
14%
14%
14%
15%
15%
15%
16%
16%
17%
18%
18%
19%
19%
20%
25%
27%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Ukraine Croatia
Netherlands
Czech Republic Germany
Ireland
Finland
Turkey
Spain
Latvia United Kingdom
Bosnia Herzegovina Slovenia
Cyprus Belgium
Sweden
Bulgaria
France
Serbia
Romania Lithuania
Greece Poland
Russian Federation
FG <6.1 mmol/L
All patients: 15%
Men 14% , Women 15%
Fasting glucose < 6.1 mmol/L in patients with diabetes
FG <7.0 mmol/L
All patients: 31%
Men 30% , Women 31%
15%
19%
21%
23%
25%
27%
30%
31%
31%
31%
32%
33%
33%
37%
38%
39%
39%
41%
42%
43%
44%
45%
51%
62%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Turkey Croatia Cyprus
United Kingdom France
Slovenia
Czech Republic
Bulgaria
Netherlands
Ireland Ukraine
Bosnia Herzegovina Lithuania
Germany Sweden
Romania
Russian Federation
Latvia
Greece
Serbia Belgium
Spain Poland
Finland
HbA1c <6.5%
All patients: 35%
Men 36% , Women 33%
HbA1c < 6.5% in patients with diabetes
HbA1c <7.0%All patients: 53%Men 54% , Women 49%
Glucose metabolism classification based on OGTT
Impaired Glucose Tolerance
Newly detected diabetes
Normoglycaemia
Impaired Fasting Glucose
Self-reported diabetes
85%
89%
89%
91%
91%
92%
92%
92%
93%
93%
94%
96%
96%
96%
96%
97%
97%
97%
98%
98%
98%
98%
99%
99%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Lithuania
United Kingdom
Germany
Bulgaria
Finland
Poland
Czech Republic
Romania
Russian Federation
Ukraine
Slovenia
Belgium
Turkey
Greece
Netherlands
Croatia
Latvia
Spain
Sweden
Bosnia Herzegovina
France
Serbia
Ireland
Cyprus
All patients: 94%
Men 94% , Women 93%
Aspirin & other antiplatelets
68%
75%
75%
78%
78%
79%
80%
80%
80%
80%
82%
83%
83%
83%
84%
84%
86%
86%
87%
88%
88%
89%
90%
94%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
United Kingdom
Netherlands
Croatia
Ukraine
Greece
Ireland
Finland
Belgium
Cyprus
Russian Federation
France
Poland
Bulgaria
Germany
Turkey
Lithuania
Czech Republic
Slovenia
Bosnia Herzegovina
Romania
Latvia
Sweden
Spain
Serbia
All patients: 83%
Men 83% , Women 83%
Beta-blockers
49%
60%
63%
64%
67%
71%
72%
73%
74%
76%
76%
78%
78%
79%
79%
80%
81%
81%
82%
82%
82%
82%
85%
87%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Belgium
Finland
Greece
Russian Federation
Netherlands
Romania
Spain
Ireland
Ukraine
Turkey
United Kingdom
Poland
Bulgaria
Slovenia
Lithuania
Croatia
Latvia
Cyprus
Sweden
Germany
France
Czech Republic
Bosnia Herzegovina
Serbia
All patients: 75%
Men 75% , Women 75%
ACE Inhibitors or ARBs
74%
75%
75%
79%
80%
81%
82%
82%
83%
84%
87%
87%
88%
89%
90%
92%
92%
93%
93%
93%
94%
94%
96%
96%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Lithuania
Russian Federation
Bulgaria
Turkey
Ukraine
Croatia
Finland
Poland
Germany
United Kingdom
Netherlands
Romania
Bosnia Herzegovina
Slovenia
Sweden
Spain
Serbia
Ireland
Czech Republic
Latvia
Belgium
France
Cyprus
Greece
All patients: 86%
Men 86% , Women 84%
Statins
Finland
Czech Republic
France
Netherlands
Slovenia
EUROASPIRE II, III & IV countries
Belgium
Ireland
UK
Poland
Prevalence of smoking, obesity* and central obesity**
21%
32%
51%
20%
33%
51%
18%
39%
57%
0%
20%
40%
60%
80%
100%
Smoking Obesity Central obesity
* BMI ≥ 30 kg/m²; **Waist circumference ≥ 88 cm for women and ≥ 102 cm for men
p=0.55
p=0.007
p=0.04
EUROASPIRE IIEUROASPIRE IIIEUROASPIRE IV
Prevalence of raised BP*, elevated LDL-C** and diabetes***
54%
96%
19%
11%
52%
80%
24%
11%
45%
75%
27%
12%
0%
20%
40%
60%
80%
100%
Raised BP Elevated LDL-C Self-reported diabetes Unknown diabetes
* SBP/DBP ≥ 140/90 mmHg (≥ 140/80 mmHg for patients with diabetes); LDL ≥ 1.8 mmol/L (≥ 70 mg/dL);
***Fasting glucose ≥ 7 mmol/L (≥ 126 mg/dL) for patients without history of diabetes
p=0.01
P<0.0001
p=0.0004
EUROASPIRE IIEUROASPIRE IIIEUROASPIRE IV
p=0.78
Therapeutic control of blood pressure*, LDL-C** and diabetes***
*In patients on BP lowering drugs; **In patients on lipid-lowering drugs; *** In patients with known diabetes
p=0.01
P<0.0001
EUROASPIRE IIEUROASPIRE IIIEUROASPIRE IV
p=0.69
Cardiovascular protective drug therapies
85%
63%
42%
55%
94%
82%
72%
89%
95%
81%
71%
89%
0%
20%
40%
60%
80%
100%
Antiplatelets Beta-blockers ACE/ARB's Statins
P<0.0001
EUROASPIRE IIEUROASPIRE IIIEUROASPIRE IV
P<0.0001
P<0.0001
P<0.0001
Conclusions
• Adverse lifestyle trends in coronary patients are a major cause for concern - with no change in prevalence of smoking habits, particularly in younger patients, and a continuing increases in obesity, central obesity and diabetes
• Despite improved blood pressure and lipid management they are still not optimally controlled
• No change in glycaemic control in patients with diabetes
• Professional support is required to make lifestyle changes and manage risk factors more effectively
• All patients should have access to modern preventive cardiology programmes combining a professional lifestyle and therapeutic intervention with effective risk factor management to reduce total cardiovascular risk
Speaker
Knowing is not enough; we must apply
Willing is not enough; we must do
Speaker
Goethe
Scientific Steering Committee Executive Committee and National co-ordinators
• Kornelia Kotseva (Chair Scientific Steering Committee) (UK)
• Guy De Backer (Chair Executive Committee) (Belgium)
• Philippe Amouyel (France)
• Dirk De Bacquer (Belgium)
• Stephan Gielen (Germany)
• Aldo Maggioni (Italy)
• Malika Manini (France)
• Lars Ryden (Sweden)
• Oliver Schnell (Germany)
• Jouko Sundvall (Helsinki)
• Jaakko Tuomilehto (Finland)
• David Wood (UK)
Speaker
National Co-ordinators
• Belgium Dirk De Bacquer, Johan
De Sutter
• Bulgaria Nina Gotcheva
• Bosnia & Herzegovina Dusko
Vulic, Mirza Dilic
• Croatia Željko Reiner, Davor
Milicic
• Cyprus Evagoras Nicolaides
• The Czech Republic Jan
Bruthans, Renata Cifkova
• Finland Seppo Lehto
• France Philippe Amouyel
• Germany Peter Heuschmann,
Stefan Stöerk
• Greece Ioannis Goudevenos
• Ireland David Moore
• Latvia Andrejs Erglis
• Lithuania Aleksandras
Laucevicius
• The Netherlands Jaap Deckers
• Poland Andrzej Pajak
• Romania Dan Gaita
• Russia Rafael Oganov, Nana
Pogosova
• Serbia Dragan Lovic
• Slovenia Zlatko Fras
• Spain Almudena Castro Conde
• Sweden Martin Stagmo, Viveca
Gyberg
• Turkey Lâle Tokgözoğlu
• Ukraine Marina Dolzhenko
• United Kingdom David Wood Speaker
Co-ordinating centreCardiovascular Medicine, International Centre for Circulatory Health
Imperial College, London, UK
• David Wood
• Kornelia Kotseva
• Catriona Jennings
• Agnieszka Adamska
Data management centreEURObservational Research Programme, European Heart House, Sophia-
Antipolis, France
• Malika Manini, Head of EORP Department
• Marème Konte, Data Manager
• Myriam Glemot, Programme Assistant
Statistical Centre Department of Public Health, Ghent University, Belgium
• Dirk De Bacquer
Speaker
Diabetes centre
Department of Cardiology Karolinska University Hospital Stockholm,
Sweden
• Lars Ryden
• Jaakko Tuomilehto
• Oliver Schnell
• Viveca Gyberg
Central LaboratoryLaboratory of Analytical Biochemistry, National Public Health Institute
Helsinki, Finland
• Jouko Sundvall
Speaker
EUROASPIRE IV
Sponsors
GlaxoSmithKline
Bristol-Myers Squibb/ Emea Sarl
AstraZeneca
F. Hoffmann La Roche
Merck Sharp & Dohme
Finland
Czech RepublicFrance
Germany
Netherlands
SloveniaSpain
EUROASPIRE IV Countries
Belgium
Ireland
UK
Greece
Poland
Latvia
Lithuania
Romania
Russia
Croatia
Bulgaria
Cyprus
Turkey
Serbia Bosnia
Herzegovina Ukraine
Sweden
13%
30%
30%
40%
40%
40%
40%
44%
45%
46%
47%
48%
50%
55%
55%
57%
58%
61%
62%
62%
64%
65%
66%
71%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Slovenia Croatia
Spain
Belgium Cyprus
Greece
France
Latvia
Netherlands
Czech Republic Bosnia Herzegovina
Sweden United Kingdom
Finland Russian Federation
Poland
Serbia
Lithuania
Germany
Ukraine Bulgaria
Turkey Ireland
Romania
Intention to quit smoking within the coming 6 months*
All patients: 50.9%
Men 52.0% , Women 45.5%
* among patients still smoking at the time of interview
25%
39%
41%
45%
46%
55%
56%
59%
59%
59%
63%
64%
65%
67%
67%
68%
70%
71%
72%
73%
75%
78%
79%
86%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Finland Cyprus
Sweden
Latvia Turkey
Lithuania
France
Croatia
Czech Republic
Ukraine Poland
Bosnia Herzegovina Spain
Netherlands Bulgaria
Russian Federation
Ireland
Greece
Serbia
Germany United Kingdom
Belgium Romania
Slovenia
All patients: 61.9%
Men 62.0% , Women 61.5%
Obese patients* considering to lose weight during next
6 months
* Body mass index ≥ 30 kg/m² at time of interview
44%
58%
58%
69%
69%
77%
80%
84%
86%
87%
87%
88%
92%
94%
95%
96%
96%
96%
97%
98%
99%
99%
100%
100%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
United Kingdom
Turkey
Ireland
Belgium
Netherlands
Greece
Sweden
Croatia
Czech Republic
Spain
Germany
France
Romania
Russian Federation
Ukraine
Bulgaria
Finland
Bosnia Herzegovina
Cyprus
Latvia
Lithuania
Poland
Serbia
Slovenia
All patients: 87%
Men 86% , Women 88%
Blood pressure level awareness
15%
18%
22%
23%
24%
30%
32%
37%
38%
39%
52%
53%
60%
61%
66%
67%
70%
72%
74%
81%
82%
82%
84%
93%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
France
Belgium
Turkey
Spain
Germany
Croatia
Netherlands
Czech Republic
United Kingdom
Sweden
Romania
Bulgaria
Cyprus
Latvia
Ukraine
Finland
Greece
Lithuania
Ireland
Russian Federation
Poland
Slovenia
Bosnia Herzegovina
Serbia
All patients: 49%
Men 47% , Women 57%
Total cholesterol level awareness
8%
22%
25%
28%
28%
33%
39%
41%
43%
45%
47%
51%
54%
56%
57%
60%
61%
64%
64%
74%
77%
85%
95%
96%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Belgium
Netherlands
United Kingdom
Germany
France
Turkey
Ireland
Croatia
Spain
Latvia
Sweden
Bulgaria
Finland
Czech Republic
Ukraine
Romania
Greece
Bosnia Herzegovina
Lithuania
Cyprus
Russian Federation
Poland
Serbia
Slovenia
All patients: 50%
Men 47% , Women 57%
Glucose level awareness
14%
20%
25%
25%
30%
30%
31%
33%
34%
34%
35%
36%
38%
41%
41%
42%
44%
46%
48%
50%
55%
56%
56%
60%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Spain
Finland
Slovenia
Ireland
Belgium
France
Sweden
United Kingdom
Latvia
Croatia
Greece
Romania
Poland
Czech Republic
Cyprus
Netherlands
Bosnia Herzegovina
Serbia
Germany
Turkey
Bulgaria
Ukraine
Russian Federation
Lithuania
TC≥ 4.5 mmol/L
All patients: 39%
Men 36% , Women 49%
Total cholesterol ≥ 4.5 mmol/L
TC≥ 4.0 mmol/L
All patients: 60%
Men 56% , Women 71%
49%
51%
52%
54%
56%
58%
59%
59%
60%
60%
62%
67%
67%
68%
70%
70%
71%
71%
73%
73%
76%
79%
84%
87%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Lithuania
Ukraine
Russian Federation
Bulgaria
Serbia
Germany
Turkey
Bosnia Herzegovina
Cyprus
Netherlands
Czech Republic
Greece
Poland
Latvia
Belgium
Romania
France
Croatia
Sweden
United Kingdom
Ireland
Slovenia
Finland
Spain
TC < 4.5 mmol/L
All patients: 66%
Men 69% , Women 56%
Total cholesterol < 4.5 mmol/L in patients on lipid-lowering medication
TC < 4.0 mmol/L
All patients: 44%
Men 47% , Women 32%
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