@article{KotsevaDeBackerDeBacqueretal.2019,
  author    = {Kotseva, Kornelia and De Backer, Guy and De Bacquer, Dirk and Ryd{\´e}n, Lars and Hoes, Arno and Grobbee, Diederick and Maggioni, Aldo and Marques-Vidal, Pedro and Jennings, Catriona and Abreu, Ana and Aguiar, Carlos and Badariene, Jolita and Bruthans, Jan and Castro Conde, Almudena and Cifkova, Renata and Crowley, Jim and Davletov, Kairat and Deckers, Jaap and De Smedt, Delphine and De Sutter, Johan and Dilic, Mirza and Dolzhenko, Marina and Dzerve, Vilnis and Erglis, Andrejs and Fras, Zlatko and Gaita, Dan and Gotcheva, Nina and Heuschmann, Peter and Hasan-Ali, Hosam and Jankowski, Piotr and Lalic, Nebojsa and Lehto, Seppo and Lovic, Dragan and Mancas, Silvia and Mellbin, Linda and Milicic, Davor and Mirrakhimov, Erkin and Oganov, Rafael and Pogosova, Nana and Reiner, Zeljko and St{\"o}erk, Stefan and Tokg{\"o}zoğlu, L{\^a}le and Tsioufis, Costas and Vulic, Dusko and Wood, David},
  title     = {Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry},
  series = {European Journal of Preventive Cardiology},
  volume    = {26},
  journal   = {European Journal of Preventive Cardiology},
  number    = {8},
  organization    = {EUROASPIRE Investigators},
  issn      = {2047-4873},
  doi       = {10.1177/2047487318825350},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-205526},
  pages     = {824-835},
  year      = {2019},
  abstract  = {Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26\%) were interviewed. Nineteen per cent smoked and 55\% of them were persistent smokers, 38\% were obese (body mass index ≥30 kg/m2), 59\% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66\% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71\% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29\% reported having diabetes. Cardioprotective medication was: anti-platelets 93\%, beta-blockers 81\%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75\% and statins 80\%. Conclusion A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.},
  language  = {en}
}
@article{GuederBrennerAngermannetal.2012,
  author    = {G{\"u}der, G{\"u}lmisal and Brenner, Susanne and Angermann, Christiane E. and Ertl, Georg and Held, Matthias and Sachs, Alfred P. and Lammers, Jan Willem and Zanen, Peter and Hoes, Arno W. and St{\"o}rk, Stefan and Rutten, Frans H.},
  title     = {"GOLD or lower limit of normal definition? a comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study"},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75193},
  year      = {2012},
  abstract  = {Background: The Global initiative for chronic Obstructive Lung Disease (GOLD) defines COPD as a fixed postbronchodilator ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) below 0.7. Agedependent cut-off values below the lower fifth percentile (LLN) of this ratio derived from the general population have been proposed as an alternative. We wanted to assess the diagnostic accuracy and prognostic capability of the GOLD and LLN definition when compared to an expert-based diagnosis. Methods: In a prospective cohort study, 405 patients aged ≥ 65 years with a general practitioner's diagnosis of COPD were recruited and followed up for 4.5 (median; quartiles 3.9; 5.1) years. Prevalence rates of COPD according to GOLD and three LLN definitions and diagnostic performance measurements were calculated. The reference standard was the diagnosis of COPD of an expert panel that used all available diagnostic information, including spirometry and bodyplethysmography. Results: Compared to the expert panel diagnosis, 'GOLD-COPD' misclassified 69 (28\%) patients, and the three LLNs misclassified 114 (46\%), 96 (39\%), and 98 (40\%) patients, respectively. The GOLD classification led to more false positives, the LLNs to more false negative diagnoses. The main predictors beyond the FEV1/FVC ratio for an expert diagnosis of COPD were the FEV1 \% predicted, and the residual volume/total lung capacity ratio (RV/TLC). Adding FEV1 and RV/TLC to GOLD or LLN improved the diagnostic accuracy, resulting in a significant reduction of up to 50\% of the number of misdiagnoses. The expert diagnosis of COPD better predicts exacerbations, hospitalizations and mortality than GOLD or LLN. Conclusions: GOLD criteria over-diagnose COPD, while LLN definitions under-diagnose COPD in elderly patients as compared to an expert panel diagnosis. Incorporating FEV1 and RV/TLC into the GOLD-COPD or LLN-based definition brings both definitions closer to expert panel diagnosis of COPD, and to daily clinical practice.},
  subject      = {Medizin},
  language  = {en}
}
@article{GuederBrennerStoerketal.2015,
  author    = {G{\"u}der, G{\"u}lmisal and Brenner, Susanne and St{\"o}rk, Stefan and Held, Matthias and Broekhuizen, Berna D. L. and Lammers, Jan-Willem J. and Hoes, Arno W. and Rutten, Frans H.},
  title     = {Diagnostic and prognostic utility of mid-expiratory flow rate in older community-dwelling persons with respiratory symptoms, but without chronic obstructive pulmonary disease},
  series = {BMC Pulmonary Medicine},
  volume    = {15},
  journal   = {BMC Pulmonary Medicine},
  number    = {83},
  doi       = {10.1186/s12890-015-0081-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125547},
  year      = {2015},
  abstract  = {Background The maximal expiratory flow at 50 \% of the forced vital capacity (MEF50) is the flow where half of forced vital capacity (FVC) remains to be exhaled. A reduced MEF50 has been suggested as a surrogate marker of small airways disease. The diagnostic and prognostic utility of this easy to assess spirometric variable in persons with respiratory symptoms, but without COPD is unclear. Methods We used data from the UHFO-COPD cohort in which 405 community-dwelling persons aged 65 years or over, and a general practitioner's diagnosis of chronic obstructive pulmonary disease (COPD) underwent pulmonary function testing and echocardiography. In total 161 patients had no COPD according to the spirometric GOLD criteria. We considered MEF50 as reduced if < 60 \% of predicted. Results Of the 161 patients without COPD (mean age 72 ± 5.7 years; 35 \% male; follow-up 4.5 ± 1.1 years), 61 (37.9 \%) had a reduced MEF50. They were older, had more pack-years of smoking, more respiratory symptoms, and used more frequently inhaled medication than the remaining 100 subjects. A reduced MEF50 was nearly twice as often associated with newly detected heart failure (HF) at assessment (29.5 \% vs. 15.6 \%, p = 0.045). In age-and sex-adjusted Cox regression analysis, a reduced MEF50 was significantly associated with episodes of acute bronchitis (hazard ratio 2.54 95 \% confidence interval (1.26; 5.13) P = 0.009), and in trend with pneumonia (2.14 (0.98; 4.69) P = 0.06) and hospitalizations for pulmonary reasons (2.28 (0.93; 5.62) P = 0.07). Conclusions In older community-dwelling persons with pulmonary symptoms but without COPD, a reduced MEF50 may help to uncover unrecognized HF, and identify those at a higher risk for episodes of acute bronchitis, pneumonia and hospitalizations for pulmonary reasons. Echocardiography and close follow-up should be considered in these patients.},
  language  = {en}
}