Chronic medication intake in patients with stable coronary heart disease across Europe: Evidence from the daily clinical practice. Results from the ESC EORP European Survey of Cardiovascular Disease Prevention and Diabetes (EUROASPIRE IV) Registry

Int J Cardiol. 2020 Feb 1:300:7-13. doi: 10.1016/j.ijcard.2019.09.015. Epub 2019 Sep 7.

Abstract

Background: As advised by the European guidelines on cardiovascular prevention, medication intake is a major component of secondary prevention. The aim of this study is to provide an in-depth overview of the medication intake in stable European coronary heart disease (CHD) patients.

Methods: Analyses are based on the EUROASPIRE IV survey, including CHD patients (18 to 80 years) who were hospitalized for a coronary event. These patients were interviewed and examined 6 months to 3 years after their hospitalization. Information on cardiovascular medication intake is available for 7953 patients.

Results: About 99.2% of patients were on any kind of cardiovascular medication and 67.6% of patients were taking at least 5 different cardiovascular drugs. Overall, even when patients are taking the recommended drug combination as advised by the European guidelines - accounting for their disease profile - a large proportion of patients is still not on blood pressure, LDL-C or HbA1c target. In addition, huge variations were seen in medication dose intake across countries. Comparing the dose intake to the defined daily dose (DDD as published by the WHO) indicated a substantial deviation from the DDDs for a large proportion of patients.

Conclusion: This study provides a unique overview of the cardiovascular medication intake in CHD patients. Overall, even when patients are taking the advised drug combination, a large proportion of patients is still not on risk factor target. Physicians should seek for a balance in medication intake and appropriate dose, accounting both for the benefits and risks of chronic drug intake.

Keywords: Coronary heart disease; EUROASPIRE; Medication.

MeSH terms

  • Aged
  • Cardiovascular Agents / administration & dosage*
  • Coronary Disease / drug therapy*
  • Coronary Disease / epidemiology
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology
  • Drug Administration Schedule
  • Europe / epidemiology
  • Evidence-Based Medicine / methods*
  • Female
  • Hospitalization / trends
  • Humans
  • Male
  • Middle Aged
  • Registries*
  • Secondary Prevention / methods*
  • Surveys and Questionnaires*

Substances

  • Cardiovascular Agents