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The Pharmaceutical Journal
Vol 269 No 7214 p310
7 September 2002

Related websites
European Society of Cardiology (www.escardio.org)

EU adopts strategy for heart disease

The heart disease plan says it is essential for health professionals to keep up to date with current practice

The European Union has committed itself to the fight against heart disease by approving a new strategy document from the European Society of Cardiology.

The ESC's "Heart plan for Europe" outlines a number of specific targets aimed at reducing the incidence of cardiovascular disease (CVD) across Europe, and cutting CVD death among the under-65s by 40 per cent by 2020. The targets are to reduce individuals' blood cholesterol to 5.0mmol/L by 2007, to reduce blood pressure among the under-65s to 140/90mmHg and to reduce the number of Europeans smoking by one per cent per year. The plan also stresses the importance of continuing education for all health professionals. The ESC says 40 per cent of those dying before 74 years in most European countries are killed by CVD.

Professor John Martin, ESC board member and professor of cardiovascular medicine at University College, London, was involved with the development of the heart plan. He commented: "Cardiovascular disease in Europe is equal in impact to the black death of the Middle Ages. But while the black death came and went in a few years, cardiovascular disease has been with us for at least 100 years and is only getting worse."

Furthermore, a new ESC survey, unveiled at the society's annual congress in Berlin earlier this week, revealed that many CVD patients across the EU do not achieve the recommended targets for blood pressure and serum cholesterol and are not receiving the care and medicines that they should be.

ESC president Professor Maarten Simoons said: "Overall, in this survey, we see undertreatment of large groups of patients — often they do not get the therapy they need and when they do, they are underdosed. Doses of the drugs are 50 per cent lower, or even more than 50 per lower."

The EU has used the ESC plan as a basis for its own formal declaration on CVD, setting treatment and monitoring objectives and those for the promotion of prevention campaigns in member states.

Updated ESC guidelines Patients suffering acute coronary syndrome (ACS) without ST segment elevation should immediately start treatment with clopidogrel (Plavix) in addition to aspirin, low molecular weight heparin, beta-blockers and nitrates, according to newly revised European Society of Cardiology guidelines.

They recommend at least nine months of clopidogrel therapy, in addition to aspirin for life, beta-blockers (if not contra-indicated) and statins, for patients classified as low-risk after baseline treatment. High-risk patients should also receive a glycoprotein IIb/IIIa inhibitor and be assessed for possible invasive intervention. Those scheduled for coronary artery bypass grafting should not be given clopidogrel unless the operation is postponed, in which case treatment can be given but must be discontinued at least five days before the operation. Clopidogrel received approval for this indication from the European Agency for the Evaluation of Medicinal Products in June.

The ESC guidelines will be published in the November issue of the European Heart Journal and subsequently on the ESC's website (www.escardio.org).