Original research article - Special issue: Cardiovascular PreventionThe changes in cardiovascular prevention practice between 1995 and 2012 in the Czech Republic. A comparison of EUROASPIRE I, II, III and IV study

Definite evidence has been established such that coronary patients benefit from appropriate secondary prevention. A series of EUROASPIRE surveys evaluated the level of implementation of coronary heart disease (CHD) prevention Guidelines. We aimed to evaluate the changes in adherence to treatment targets during 16 years and to compare the mortality in Czech patients with manifest CHD.Four independent descriptive surveys were undertaken in 1995/96, 1999/2000, 2006/07 and 2012/13. Consecutive patients less than 71 years of age suffering for acute coronary event and/or revascularization procedure were identified and examined at least 6 months afterwards.The study population included 4 series of 331, 410, 421 and 372 patients.The prescription of basic pharmacotherapy markedly improved, namely use of statins increased more than 12 times (from 7.3% to 93.3%). Proportion of patients who underwent revascularization increased from 49% to 95%. Prevalence of hypercholesterolemia and raised blood pressure significantly decreased from 87% to 39% and from 64% to 40%, respectively. 10-years all-cause mortality rates decreased significantly between 1995 and 1999 from 28% to 18%. On the other hand, proportion on smoking did not change significantly, while prevalence of overt diabetes increased more than twice. In conclusion, in spite that the compliance with the recommendations for secondary prevention markedly improved in single factors, global achievement of desired target remained rather unsatisfactory, likewise in other European countries.