Clinical evidence: The EUROACTION Trial

Cardiovascular Disease Prevention - Risk Assessment and Management

EUROACTION is a cluster randomised controlled trial to assess the clinical effectiveness of a comprehensive approach to cardiovascular prevention. The trial’s key findings included:

  • Collaboration across disciplines – nurses, dieticians, physiotherapists, cardiologists and general practitioners - reduces cardiovascular risk
  • Family involvement increases patient commitment to lifestyle changes and treatment
  • Preventive cardiology programmes are required for all coronary and high risk patients but must be adapted to local medical, cultural and economic settings

The single largest research project ever to be undertaken by the European Society of Cardiology (ESC), EUROACTION, showed that a multidisciplinary, family based and nurse coordinated programme made a real difference in improving lifestyle and reducing cardiovascular risk among coronary patients and people with a high risk of developing Cardiovascular Disease (CVD). EUROACTION implicated six pairs of hospitals and six pairs of general practices in eight European countries (including the UK). The trial involved over 10 000 coronary and high risk patients and lasted 3 years.

“EUROACTION is a landmark study showing that preventive goals can be achieved and are sustainable in everyday clinical practice” explains Prof Kim Fox, President of the ESC. Previous studies conducted by the ESC – Euroaspire I, II and III- showed that CVD prevention in routine clinical practice was inadequate, with only a third of patients attending cardiac rehabilitation programmes and a high percentage not achieving weight, blood pressure and lipid targets. Researchers discovered that individuals left to themselves find it hard to adhere to recommended lifestyle changes and prescribed treatments. These include smoking cessation, changes in diet, increasing physical activity, controlling central obesity, blood pressure, cholesterol and glucose.
The EUROACTION intervention used behavioural techniques and expert advice to address individuals’ particular problems and personal challenges. The second key element was involving spouses: reducing weight or giving up smoking is difficult to accomplish if families do not feel concerned. By fully including partners or significant others EUROACTION helped both patients and their families benefit from healthier lifestyles.

There was an excellent uptake to EUROACTION with a large majority of coronary and high risk patients, and their families, being recruited and completing this comprehensive preventive cardiology programme. EUROACTION patients reduced their consumption of saturated fat: three quarters of patients and their partners achieved the recommended fruit and vegetable consumption, compared to just over a third of usual care patients and twice as many met the recommended weekly intake of oily fish. Partners of EUROACTION patients showed the same trend of change for diet. Over half of patients stopped smoking and remained non-smokers after one year. Physical activity targets of 30-45 minutes of exercise four to five items per week were achieved by twice as many EUROACTION patients as compared to usual care patients, and partners of EUROACTION patients also increased their physical activity.

Helping patients to make healthy lifestyle changes and take medicines poses considerable challenges for cardiology and general practice. EUROACTION shows that support from a multidisciplinary health care team and family involvement makes a real difference.

MyAction now works towards establishing preventive cardiology programmes which are accessible by all coronary and high risk patients across the UK. Cardiovascular disease remains one of the main causes of death in the UK. EUROACTION and its successor MyAction show us a practical way of reducing the burden of heart disease and stroke.

For more information visit: www.escardio.org/euroaction
The EUROACTION results are published in the Lancet: (Wood et al, June 2008 371:1999-2012)
Link to Lancet website: www.thelancet.com

  • Our Cardiovascular Prevention team at Imperial College. Meet the team.
  • Unique features of the programme. More about the programme.
  • Setting up and running a MyAction programme.The principles of partnering with Myaction.

What the patients say:

“Thank you, it has been invaluable and I know a number of people who would benefit from the programme. We have nothing but praise for the care and attention to detail from the MyAction team. Without their intervention my husband would not have been introduced to statins, until possibly too late. They have made a profound difference and awareness to our lifestyles”

“I am very happy that I was offered this opportunity and feel that I am so much fitter and well. I will be continuing with the lifestyle and changes I have made as a result of MyAction. Thanks to all concerned. I found everyone most helpful, pleasant and encouraging.”

“Very professional and caring team who I found to be encouraging at all times. The MyAction nurse was very good in helping me with suitable medication to manage my blood pressure and cholesterol in conjunction with my GP practice. The studio exercise sessions were fun, and the physical activity specialist ensured everyone joined in up to their personal physical ability (the patients not the specialists). Thank you for a very enjoyable experience, it is great to see preventative action being taken before it’s too late in later years.”

“An excellent programme executed
by a brilliant team of
fine individuals”