SUrvey of Risk Factors in Coronary Heart Disease (SURF CHD): A clinical audit program of cardiovascular risk factor management in daily practice

Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide. The top priority of secondary prevention is to control modifiable risk factors. However, current cardiovascular risk factor management remains inadequate and monitoring programs, like clinical audits, are lacking. Objectives: i> to summarize the importance of clinical audits in daily practice; ii> to describe CVD risk factor recording and management in routine practice; iii> to assess potential determinants within and between different geographic regions; and iv> to summarize the use of cardiovascular medication in China. Results: The consistency and representativeness of existing clinical audits were still limited. SURF CHD (SUrvey of Risk Factors Coronary Heart Disease) was a straightforward and targeted clinical audit to simplify the recording and monitoring of routine CVD risk factors. SURF recruited 10,186 CHD patients in 11 countries among three different regions (Europe, Asia, and the Middle East). Recording and management of CVD risk factor was generally poor. Over 80% of participants had inadequate risk factor management with less than five risk factors being controlled. SURF found several characteristics had significant impacts on cardiovascular risk factor management. Women were less likely to achieve targets for total cholesterol (odds ratio 0.50, 95% confidence interval 0.43-0.59), low-density lipoprotein cholesterol (LDL) (OR 0.57, 95% CI 0.51-0.64), and glucose (OR 0.78, 95% CI 0.70-0.87), or to be physically active (OR 0.74, 95% CI 0.68-0.81) or non-obese (OR 0.82, 95% CI 0.74-0.90). Furthermore, to control three or more risk factor was less likely to be reached by women (OR 0.84. 95% CI 0.74-0.95), and those aged