Aims To provide contemporary data on the implementation of European guideline recommendations for lipid-lowering therapies (LLTs) across different settings and populations and how this impacts low-density lipoprotein cholesterol (LDL-C) goal achievement. Methods and results An 18 country, cross-sectional, observational study of patients prescribed LLT for primary or secondary prevention in primary or secondary care across Europe. Between June 2017 and November 2018, data were collected at a single visit, including LLT in the preceding 12 months and most recent LDL-C. Primary outcome was the achievement of risk-based 2016 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888 patients (3000 primary and 2888 secondary prevention patients) were enrolled; 54% [95% confidence interval (CI) 52–56] achieved their risk-based 2016 goal and 33% (95% CI 32–35) achieved their risk-based 2019 goal. High-intensity statin monotherapy was used in 20% and 38% of very high-risk primary and secondary prevention patients, respectively. Corresponding 2016 goal attainment was 22% and 45% (17% and 22% for 2019 goals) for very high-risk primary and secondary prevention patients, respectively. Use of moderate–high-intensity statins in combination with ezetimibe (9%), or any LLT with PCSK9 inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i combination). Conclusion Gaps between clinical guidelines and clinical practice for lipid management across Europe persist, which will be exacerbated by the 2019 guidelines. Even with optimized statins, greater utilization of non-statin LLT is likely needed to reduce these gaps for patients at highest risk.

In children and adolescents, 3-day monitoring with duplicate morning and evening measurements appears to be the minimum schedule for the reliable assessment of HBP.

PAD patients have a high risk of all-cause and cardiovascular (CV) mortality.• Patients with critical limb ischaemia were at highest risk (versus ABI < 0.9). • Fewer patients with critical limb ischaemia received statins (versus ABI < 0.9). • The risk of stroke or MI is at least equivalent to that of coronary artery disease.• Improved treatments are needed to attenuate CV risk in PAD patients.

In children and adolescents, there is a reasonable agreement between home and ambulatory blood pressure measurements as diagnostic methods in hypertension. Home blood pressure appears to be a useful diagnostic test in this population, particularly for the detection of white-coat hypertension.

Eighteen well motivated patients with advanced chronic obstructive pulmonary disease, who had had at least four hospitalizations during the previous two years, were included in a home-based telemedicine study. A visiting nurse was equipped with a case containing a laptop computer and a number of medical devices, including an electrocardiogram recorder, spirometer, oximeter and blood pressure monitor. It also contained a videoconference camera, for realtime audiovisual connection with the hospital using the patient's TV set. A single ISDN line (128 kbit/s) was installed in each house before the study began. After nine months, there was a decrease in hospitalizations, emergency department visits and use of health services. The patient's disease knowledge and self-management also improved. It seems likely that adopting telemedicine in everyday clinical practice could substantially improve the care of chronically ill patients.