1、,Epidemiology of Cardiovascular Disease,Major Types of Cardiovascular Disease (CVD),Adapted from Mackay J, Mensah G, eds. The Atlas of Heart Disease and Stroke. The WHO and the US CDC, 2004.,Coronary heart disease (CHD) Rheumatic heart disease Congenital heart disease,Stroke,Aortic aneurysm and diss
2、ection,Deep venous thrombosis and pulmonary embolism,Peripheral artery disease,Deaths Due to CHD and Stroke in Europe,Adapted from Allender S, et al. European Cardiovascular Statistics, 2008. http:/www.ehnheart.org/files/statistics%202008%20web-161229A.pdf. Accessed 9 November 2008.,960,632,494,188,
3、963,404,744,550,0,200,000,400,000,600,000,800,000,1,000,000,1,200,000,CHD,Stroke,Total Number of Deaths in Latest Available Year,Men Women,Deaths Due to CVD vs Other Diseases in Europe,Men,Adapted from Allender S, et al. European Cardiovascular Statistics, 2008. http:/www.ehnheart.org/files/statisti
4、cs%202008%20web-161229A.pdf. Accessed 9 November 2008.,Injuries and poisoning,All other causes,Stroke,CHD,Respiratory disease,Stomach cancer,Colorectal cancer,Other cancer,Other CVD,Lung cancer,17%,12%,7%,11%,6%,2%,2%,11%,11%,21%,Injuries and poisoning,All other causes,Stroke,CHD,Respiratory disease
5、,Stomach cancer,Colorectal cancer,Other cancer,Other CVD,Lung cancer,18%,5%,6%,9%,2%,2%,1%,15%,17%,22%,Breast cancer,3%,Women,Cardiovascular Mortality Increases Sharply With Serum Cholesterol Concentration in Patients With Diabetes,Adapted from Stamler J, et al. Diabetes Care. 1993;16:434444.,Deaths
6、 per 10,000 Person-Years,100,50,0,Cholesterol Level,150,180 mg/dL,200219 mg/dL,240259 mg/dL,280 mg/dL,(n=62,448),(n=1105),(n=75,122),(n=1038),(n=40,090),(n=529),(n=17,604),(n=353),No diabetes Diabetes,The Gap Between CHD Prevention Guidelines and Practice,Statin therapy effectively reduces the risk
7、of mortality and major coronary events in individuals with hypercholesterolemia or hyperlipidemic patients with or without CHD. Nevertheless, there is a wide gap between target LDL-C levels established by treatment guidelines and those achieved in clinical practice.,Adapted from Waters DD. Am J Mana
8、g Care. 2001;7:S138S143; Graham I, et al. Eur J Cardiovasc Prev Rehabil. 2007;14(suppl 2):E1E40; National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA. 2001;285(19):24862497; Pearson TA, et al. Arch Intern Med. 2000;160:
9、459467.,Only 15.5% of German Physicians Reported Knowledge of ESC Guidelines for CHD Prevention,N=1023 Physicians surveyed. ESC Guidelines=European Society of Cardiology Guidelines; German Guidelines=German Society of Cardiology/German Society of Cardiac Prevention and Rehabilitation Guidelines; AHA
10、/ACC Guidelines=American Heart Association Guidelines/American College of Cardiology. Adapted from Heidrich J, et al. Eur J Cardiovasc Prev Rehabil. 2005;12(6):521529.,70,63.6,15.5,36,0,10,20,30,40,50,60,70,80,90,100,At Least 1 Guideline,German Guidelines,ESC Guidelines,AHA/ACC Guidelines,Physicians
11、 Reporting Knowledge, %,Only 15% of European Primary Care Physicians Surveyed Adhered to Current European CVD Prevention Guidelines,Adapted from Hobbs FD, Erhardt L. Fam Pract. 2002;19(6):596604.,Believe in the Need for Formal Guidelines,Agree With the Content of Current Guidelines,Currently Use Eur
12、opean Guidelines,0,10,20,30,40,50,60,70,80,90,100,Physicians Who Believed Statement, %,87,89,15,EUROASPIRE II: Almost 40% of At-Risk Patients With Hyperlipidemia Did Not Receive Dietary Advice,N=4306 Patients with a history of hyperlipidemia. EUROASPIRE=European Action on Secondary Prevention throug
13、h Intervention to Reduce Events; CABG=coronary artery bypass graft; PTCA=percutaneous transluminal coronary angioplasty; AMI=acute myocardial infarction. Adapted from EUROASPIRE II Study Group. Eur Heart J. 2001;22:554572.,0,10,20,30,40,50,60,70,80,90,100,Patients Receiving Dietary Advice, %,62,66.6
14、,61.9,56.5,62.2,Post-CABG,Post-PTCA,Post-AMI,Ischemic,Total,EUROASPIRE II: Almost 40% of At-Risk Patients With Hyperlipidemia Did Not Receive Lipid-Lowering Therapy,Adapted from EUROASPIRE II Study Group. Eur Heart J. 2001;22:554572.,Lipid-Lowering Medication (n=3180) No Lipid-Lowering Medication (n
15、=2044),39%,61%,0,10,20,30,40,50,60,70,80,90,100,Patients, %,EUROASPIRE II: Only 51% of Patients on Lipid-Lowering Therapy Achieved Total Cholesterol Goala,aTotal cholesterol 190 mg/dL (5 mmol/L). Adapted from EUROASPIRE II Study Group. Eur Heart J. 2001;22:554572.,Center,Patients, %,39,31,70,44,41,4
16、2,48,55,49,66,49,41,52,65,54,51,Belgium,Czech Republic,Finland,France,Germany,Greece,Hungary,Ireland,Italy,Netherlands,Poland,Slovenia,Spain,Sweden,UK,All,0,20,40,60,80,100,57%b not achieving goal,aFrance, Germany, Italy, and Spain; bPercentage of high-risk patients not achieving LDL-C goal. REALITY
17、=Return on Expenditure Achieved for Lipid Therapy. Adapted from Van Ganse E, et al. Curr Med Res Opin. 2005;21(9):13891399.,REALITY Study: Most Patients Did Not Achieve LDL-C Goal of 100 mg/dL in 4 European Countriesa,Summary,CVD (primarily CHD and stroke) is the most common cause of mortality in Eu
18、rope. Although dyslipidemia is a modifiable risk factor, studies in Europe showed A Knowledge Gap A minority of German physicians surveyed reported knowledge of ESC guidelines An Action Gap A minority of European physicians surveyed were treating patients according to ESC guidelines A Treatment Gap
19、Only half of at-risk patients were achieving total cholesterol goals Less than half of hyperlipidemic patients were achieving LDL-C goals,Adapted from Allender S, et al. European Cardiovascular Statistics, 2008. http:/www.ehnheart.org/files/statistics%202008%20web-161229A.pdf. Accessed 9 November 20
20、08; Mackay J, Mensah G, eds. The Atlas of Heart Disease and Stroke. The WHO and the US CDC, 2004; Grundy SM, et al. Circulation. 2000;101:E3E11; Heidrich J, et al. Eur J Cardiovasc Prev Rehabil. 2005;12(6):521529; Wood D, et al. Atherosclerosis. 1998; 140:199270; Hobbs FD, Erhardt L. Fam Pract. 2002
21、;19(6):596604; EUROASPIRE II Study Group. Eur Heart J. 2001;22:554572; Van Ganse E, et al. Curr Med Res Opin. 2005;21(9):13891399.,Bibliography,Please see notes page.,Epidemiology of Cardiovascular Disease,Before prescribing, please consult the manufacturers Prescribing Information.MSP does not recommend the use of any product in any different manner than as described in the Prescribing Information.,Copyright 2008, 2009 MSP Singapore Company, LLC. All rights reserved. (1-10) VYT 2008-W-1274610-SS,
