Physicians' lifestyle advice on primary and secondary cardiovascular disease prevention in Germany: A comparison between the STAAB cohort study and the German subset of EUROASPIRE IV

Author:

Tiffe Theresa12,Morbach Caroline13,Malsch Carolin12,Gelbrich Götz12,Wahl Valerie12,Wagner Martin12,Kotseva Kornelia4,Wood David4,Leyh Rainer15,Ertl Georg1,Karmann Wolfgang6,Störk Stefan13,Heuschmann Peter U127,

Affiliation:

1. Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany

2. Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany

3. Department of Medicine I, University Hospital Würzburg, Germany

4. Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, UK

5. Department of Cardiovascular Surgery, University Hospital Würzburg, Germany

6. Department of Medicine, Klinik Kitzinger Land, Kitzingen, Germany

7. Clinical Trial Centre, University Hospital Würzburg, Germany

Abstract

Abstract Background We assessed prevalence and determinants in appropriate physician-led lifestyle advice (PLA) in a population-based sample of individuals without cardiovascular disease (CVD) compared with a sample of CVD patients. Methods PLA was assessed via questionnaire in a subsample of the population-based Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort free of CVD (primary prevention sample) and the German subset of the fourth EUROASPIRE survey (EUROASPIRE-IV) comprising CVD patients (secondary prevention sample). PLA was fulfilled if the participant reported having ever been told by a physician to: stop smoking (current/former smokers), reduce weight (overweight/obese participants), increase physical activity (physically inactive participants) or keep to a healthy diet (all participants). Factors associated with receiving at least 50% of the PLA were identified using logistic regression. Results Information on PLA was available in 665 STAAB participants (55 ± 11; 55% females) and in 536 EUROASPIRE-IV patients (67 ± 9; 18% females). Except for smoking, appropriate PLA was more frequently given in the secondary compared with the primary prevention sample. Determinants associated with appropriate PLA in primary prevention were: diabetes mellitus (odds ratio (OR) 4.54; 95% confidence interval (CI) 1.88–10.95), hyperlipidaemia (OR 3.12; 95% CI 2.06–4.73) and hypertension (OR 1.74; 95% CI 1.15–2.62); in secondary prevention: age (OR per year 0.96; 95% CI 0.93–0.98) and diabetes mellitus (OR 2.33; 95% CI 1.20–4.54). Conclusions In primary prevention, PLA was mainly determined by the presence of vascular risk factors, whereas in secondary prevention the level of PLA was higher in general, but the association between CVD risk factors and PLA was less pronounced.

Funder

STAAB cohort study is supported by the German Ministry of Research and Education within the Comprehensive Heart Failure Centre Würzburg

German Ministry of Education and Research (BMBF) within the Comprehensive Heart Failure Centre Würzburg (BMBF

European Society of Cardiology

EURObservational Research Programme

European Society of Cardiology from AstraZeneca

Bristol-Myers Squibb/Emea Sarl

GlaxoSmithKline, F. Hoffman-La Roche

Merck

Sharp & Dohme and Amgen

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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