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Cardiac risk factors and prevention
Original research
ASPIRE-3-PREVENT: a cross-sectional survey of preventive care after a coronary event across the UK
  1. Catriona S Jennings1,2,
  2. Kornelia Kotseva1,2,
  3. Paul Bassett1,
  4. Agnieszka Adamska1,2 and
  5. David Wood1,2
  6. on behalf of the ASPIRE-3-PREVENT Investigators
    1. 1NHLI, Imperial College London, London, UK
    2. 2National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Galway, Ireland
    1. Correspondence to Dr Catriona S Jennings; catriona.jennings{at}nuigalway.ie

    Abstract

    Objective To quantify the implementation of the third Joint British Societies’ Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3) after coronary event.

    Methods Using a cross-sectional survey design, patients were consecutively identified in 36 specialist and district general hospitals between 6 months and 2 years, after acute coronary syndrome or revascularisation procedure and invited to a research interview. Outcomes included JBS3 lifestyle, risk factor and therapeutic management goals. Data were collected using standardised methods and instruments by trained study nurses. Blood was analysed in a central laboratory and a glucose tolerance test was performed.

    Results 3926 eligible patients were invited to participate and 1177 (23.3% women) were interviewed (30% response). 12.5% were from black and minority ethnic groups. 45% were persistent smokers, 36% obese, 52.9% centrally obese, 52% inactive; 30% had a blood pressure >140/90 mm Hg, 54% non-high-density lipoprotein ≥2.5 mmol/L and 44.3% had new dysglycaemia. Prescribing was highest for antiplatelets (94%) and statins (85%). 81% were advised to attend cardiac rehabilitation (86% <60 years vs 79% ≥60 years; 82% men vs 77% women; 93% coronary artery bypass grafting vs 59% unstable angina), 85% attended if advised; 69% attended overall. Attenders were significantly younger (p=0.03) and women were less likely to attend (p=0.03).

    Conclusions Patients with coronary heart disease (CHD) are not being adequately managed after event with preventive measures. They require a structured preventive cardiology programme addressing lifestyle, risk factor management and adherence to cardioprotective medications to achieve the standards set by the British Association for Cardiovascular Prevention and Rehabilitation and JBS3 guidelines.

    • cardiac rehabilitation
    • hypertension
    • smoking
    • epidemiology
    • delivery of care
    http://creativecommons.org/licenses/by-nc/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/openhrt-2019-001196

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      Footnotes

      • Collaborators Imperial College London, National Heart and Lung Institute: D Wood*, A Adamska, S Adamska, C Jennings, K Kotseva. England Academic Cardiology, Castle Hill Hospital, Hull: A Hoye* P Atkin, D Fellowes. Barnsley Hospital NHS Foundation Trust: A Negahban*, M Cunningham, A Daniels, L Zeidan. Basildon University Hospital: Dr S Iyer*, A Nicholson, M Ocampo, A Sevillano. Blackpool Teaching Hospitals: G Galasko*, L Benham, S Preston, D Sebastian. Bradford Teaching Hospitals NHS Foundation Trust Bradford: S Lindsay*, C Atkinson, C Kranilla, M Vinod. Hammersmith Hospital: D Wood*, H Abbass, N Rhoualmi. Harrogate District NHS Foundation Trust: Y Beerachee*, C Bennett, M Broome, A Bwalya, Lindsay Caygill, L Dinning, A Gillespie, R Goodfellow, J Guy, T Idress, C Mills, C Morgan, N Oustance, N Singh, M Yare. Hinchingbrooke Hospital: J M Jagoda*, H Bowyer, V Christenssen, A Groves. King’s Mill Hospital Sherwood Forest Hospitals: A Jan PI*, A Riaz*, M Gill, T A Sewell. Lister Hospital, Stevenage: Professor D Gorog*, M Baker, P de Sousa, T Mazenenga. London Northwest University Healthcare NHS Trust, Northwick Park Hospital, London: J Shah*, A Banfield, R Encarnado, A Taylor. Luton and Dunstable University Hospital: C Travill*, S Gent, N Hussain. North West Anglia NHS Foundation Trust: J Porter*, F Haines, T Peachey, J Taaffe, K Wells. Northumbria Healthcare NHS Foundation Trust: D P Ripley*, H Forward, H McKie, S L Pick, H E Thomas. Mid Yorkshire Hospitals NHS Trust: P D Batin*, D Exley, T Rank, J Wright. Milton Keynes University Hospital: A Kardos*, S-B Sutherland, L Wren. Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital: P Leeson*, D Barker, B Moreby, J Sawyer. Pennine Acute Hospitals NHS Trust, The Royal Oldham Hospital: J Sobolewska*, D Adams, C Corbett, K Hallett, S Kaye, L Morby, L Winstanley. Royal Berkshire Foundation NHS Trust: J Stirrup*, M Brunton. Royal Devon & Exeter Hospital, Exeter: M M Gandhi*, L Adams, A Hunt. University Hospital Coventry: L Tapp*, V Ansell, S Hyndman. University Hospitals of Morecambe Bay NHS Foundation Trust: A Brodison*, J Craig, S Peters. West Middlesex University Hospital: R Kaprielian*, A Bucaj, K Mahay, M Oblak. Wrightington Wigan and Leigh NHS Foundation Trust: A Sultan*, K Duell, M Gaskell, L Heaton, C Moore, V Parkinson, T Taylor, C Tierney, K Vandesnepscheut-Jones. Yeovil District Hospital: A Broadley*, C Buckley, L Matthews, L Pippard. York Teaching Hospital: C Gale*, M Pye*, Y McGill, H Redfearn, M Fearnley. NIHR Clinical Research Network: East Midlands, Eastern, Greater Manchester, North East and North Cumbria, North Thames, North West Coast, North West London, South West Peninsula, Thames Valley and South Midlands, West Midlands, Yorkshire and Humber. Northern Ireland: Antrim Area Hospital, Northern Ireland: K Lyons*, C Edwards, L Miskelly, S O Mullan. Royal Victoria Hospital, Belfast Health and Social Care Trust: M Spencer*, E McCart. Ulster Hospital Belfast: P Donnelly*, S Kelly, S Regan, D Turnbull. Scotland: Aberdeen Royal Infirmary: Dana Dawson*, B Brikinns, S Joseph. Golden Jubilee National Hospital: Oldroyd K*, Teyhan F, Kelly J, Tewkesbury A. Royal Infirmary of Edinburgh: D Newby*, S Clark, K Combe, L Derr, J Donnelly, L Flint, A Gill, M Glenwright, J Harrison, H Nailon, K Orr, E McDonald, C Mahoney, F Morrow, K Paterson, B Poulose, B Rif, N Spath H Spence, A Sutherland. Raigmore Hospital: J Watt*, C Barr, S Dekker, D McDonald, L O'Keeffe, I Shread. University of Dundee: C C Lang*, A M Choy, L Douglas, S Kalra, M Mohan, R Symon. Wales: Abertawe Bro Morgannwg University Health Board: J Halcox*, K Baldwin, H Goldring, C Thomas. Prince Philip Hospital: L Izzat *, D Evans, Z Omar, E Perkins. (* indicates the principal investigator)

      • Contributors All authors contributed to the design, conduct, analysis and interpretation of results and take full responsibility as authors for the manuscript.

      • Funding This survey was funded by research grants from Amgen, AstraZeneca, Novartis, Pfizer and Sanofi through the European Society of Cardiology and the Preventive Cardiology Trust (Registered UK Charity).

      • Competing interests None declared.

      • Patient consent for publication Not required.

      • Ethics approval Ethics approval was obtained from the London Central Research Ethics Committee in Spring 2016 (REC reference number 16/LO/0432).

      • Provenance and peer review Not commissioned; externally peer reviewed.

      • Data availability statement Data are available upon reasonable request.