Comparison of treatment outcomes in patients with and without diabetes mellitus attending a multidisciplinary cardiovascular prevention programme (a retrospective analysis of the EUROACTION trial)

Abstract

The objective was to compare the improvements in lifestyle and risk factor profiles in patients with and without diabetes mellitus (DM) in the intervention arm of EUROACTION study. Methods: This was a retrospective analysis of the intervention arm of EUROACTION trial. Primary outcome was proportions meeting the European targets for not smoking, diet, physical activity (PA), body mass index (BMI), waist circumference (WC), blood pressure (BP), total and low-density lipoprotein (LDL) cholesterol and cardio-protective drug use at one year. Results: 179 and 777 coronary patients with and without DM, and 340 and 917 high-risk individuals (HRI) with and without DM, respectively were identified. The proportions of coronary patients achieving the lifestyle targets improved from the initial assessment (IA) except non-smoking, which reduced. At one year, significantly fewer patients with DM attained the targets for BMI (13.2% vs 31.3%, p = 0.002) and BP <140/90 mmHg (53.5% vs 74.0%, p < 0.001) compared to patients without DM despite a higher proportion of patients with DM prescribed angiotensin converting enzyme inhibitors/angiotensin receptor blockers (79.1% vs 65.3%, p = 0.021). Conclusions: Multidisciplinary intervention had a beneficial effect on several cardiovascular risk factors in both patients with and without DM. Poorer achievement of mostly lifestyle (and BP in coronary patients) targets among those with DM emphasises the need for more intensive lifestyle modification and BP management for the prevention of cardiovascular disease.