ReviewEuropean Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts)☆,☆☆
Section snippets
Why is prevention of cardiovascular disease needed?
Key messages
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Atherosclerotic CVD, especially CHD, remains the leading cause of premature death worldwide.
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CVD affects both men and women; of all deaths that occur before the age of 75 years in Europe, 42% are due to CVD in women and 38% in men.
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CVD mortality is changing, with declining age-standardized rates in most European countries, which remain high in Eastern Europe.
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Prevention works: >50% of the reductions seen in CHD mortality relate to changes in risk factors, and 40% to improved treatments.
Strategies and risk estimation
Key messagesThe detailed SCORE charts with integrated HDL-cholesterol values can be found on http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/cvd-prevention.aspxin the related materials section. In apparently healthy persons, CVD risk is most frequently the result of multiple interacting risk factors. A risk estimation system such as SCORE can assist in making logical management decisions, and may help to avoid both under-and overtreatment. Certain individuals are at high CVD risk without needing risk scoring and require immediate intervention for all risk factors. In younger persons, a low absolute risk may conceal a very high relative risk, and use of the relative risk chart
Principles of behaviour change
Key message
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Cognitive-behavioural methods are effective in supporting persons in adopting a healthy [195], [196], [197], [198], [199], [200].
Where should programmes be offered?
Key message
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Cardiovascular disease is the single most important cause of death for both men and women and can often be prevented!
Introduction
As mentioned in Section 2, prevention of CVD is a lifetime approach, starting ideally before birth by educating young parents, and continuing in the pre-school age (kindergarten) and throughout the advancing grades of the school system. During this phase, the emphasis should be on conveying the pleasures of healthy nutrition and the joys and feelings of
References (568)
- et al.
Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries
Lancet
(2009) - et al.
Differing perspectives on preventive care guidelines: a new look at the mammography controversy
Am J Prev Med
(1999) - et al.
Coronary heart disease mortality among young adults in the U.S. from 1980 through 2002: concealed leveling of mortality rates
J Am Coll Cardiol
(2007) - et al.
Early onset of coronary artery disease after prenatal exposure to the Dutch famine
Am J Clin Nutr
(2006) - et al.
Adolescent blood pressure and blood pressure tracking into young adulthood are related to subclinical atherosclerosis: the Atherosclerosis Risk in Young Adults (ARYA) study
Am J Hypertens
(2003) Evidence-based medicine and treatment choices
Lancet
(1997)- et al.
Rapid mortality falls after risk-factor changes in populations
Lancet
(2011) - et al.
Nurse-coordinated multidisciplinary, familybased cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster-randomised controlled trial
Lancet
(2008) - et al.
Prevention of coronary heart disease in clinical practice: recommendations of the second joint task force of European and other societies on coronary prevention
Atherosclerosis
(1998) - et al.
Cardiovascular disease risk profiles
Am Heart J
(1991)
HDL cholesterol protects against cardiovascular disease in both genders, at all ages and at all levels of risk
Atherosclerosis
HDL cholesterol protects against cardiovascular disease in both genders, at all ages and at all levels of risk
Atherosclerosis
Relation of heart rate at rest and long-term (>20 years) death rate in initially healthy middle-aged men
Am J Cardiol
Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial
Lancet
Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial
Lancet
Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebocontrolled study
Lancet
ESC/EAS guidelines for the management of dyslipidaemias. The task force for the management of dyslipidaemias of the European society of cardiology (ESC) and the European atherosclerosis society (EAS)
Atherosclerosis
Usefulness of cardiovascular family history data for populationbased preventive medicine and medical research (the Health Family Tree Study and the NHLBI Family Heart Study)
Am J Cardiol
Outcomes of interest in evidence-based evaluations of genetic tests
Genet Med
Depression as a predictor for coronary heart disease. a review and meta-analysis
Am J Prev Med
Risk estimation and the prevention of cardiovascular disease
A Natl Clin Guidel
Joint WHO/FAO expert consultation on diet, nutrition and the prevention of chronic diseases
Systematic review of guidelines on cardiovascular risk assessment: which recommendations should clinicians follow for a cardiovascular health check?
Arch Intern Med
The political power of heart doctors: with the European Heart Health Charter towards a European policy on cardiovascular disease
Eur J Cardiovasc Prev Rehabil
Attributes of clinical guidelines that influence use of guidelines in general practice: observational study
BMJ
GRADE: an emerging consensus on rating quality of evidence strength of recommendations
BMJ
What is ‘quality of evidence’ and why is it important to clinicians?
BMJ
Grading quality of evidence and strength of recommendations for diagnostic tests and strategies
BMJ
Coronary heart disease epidemics: not all the same
Heart
European cardiovascular disease statistics
Mortality from cardiovascular and cerebrovascular diseases in Europe and other areas of the world: an update
Eur J Cardiovasc Prev Rehabil
MONICA monograph and multimedia sourcebook
Is the decline in coronary attack rates leveling off in Flanders?
Eur J Cardiovasc Prev Rehabil
Sick individuals and sick populations
Int J Epidemiol
Revisiting Rose: strategies for reducing coronary heart disease
BMJ
Growth in utero and during childhood among women who develop coronary heart disease: longitudinal study
BMJ
Treatment of hypertension in patients 80 years and older: the lower the better? A meta-analysis of randomized controlled trials
J Hypertens
Smoking cessation interventions and older adults
Prog Cardiovasc Nurs
Trends in acute coronary heart disease mortality, morbidity, and medical care from 1985 through 1997: the Minnesota heart survey
Circulation
Association of the California Tobacco Control Program with declines in cigarette consumption and mortality from heart disease
N Engl J Med
Explaining the decrease in U.S. deaths from coronary disease, 1980–2000
N Engl J Med
Does surveillance impact on cardiovascular prevention?
Eur Heart J
Prevention of cardiovascular disease: Costing report
Nice Public Health Guidance
EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries
Eur J Cardiovasc Prev Rehabil
EUROASPIRE III. Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries
Eur J Cardiovasc Prev Rehabil
Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update
Circulation
European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts)
Eur J Cardiovasc Prev Rehabil
Prevention of coronary heart disease in clinical practice. Recommendations of the task force of the European society of cardiology, European atherosclerosis society and European society of hypertension
Eur Heart J
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Disclaimer. The ESC Guidelines represent the views of the ESC and were arrived at after careful consideration of the available evidence at the time they were written. Health professionals are encouraged to take them fully into account when exercising their clinical judgement. The guidelines do not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patients, in consultation with that patient, and where appropriate and necessary the patient's guardian or carer. It is also the health professional's responsibility to verify the rules and regulations applicable to drugs and devices at the time of prescription.
The disclosure forms of the authors and reviewers are available on the ESC website www.escardio.org/guidelines
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Other experts who contributed to parts of the guidelines: Marie Therese Cooney (Ireland). ESC Committee for Practice Guidelines (CPG): Jeroen Bax (Chairman) (The Netherlands), Helmut Baumgartner (Germany), Claudio Ceconi (Italy), Veronica Dean (France), Christi Deaton (UK), Robert Fagard (Belgium), Christian Funck-Brentano (France), David Hasdai (Israel), Arno Hoes (The Netherlands), Paulus Kirchhof, (Germany), Juhani Knuuti (Finland), Philippe Kolh (Belgium), Theresa McDonagh (UK), Cyril Moulin (France), Bogdan A. Popescu (Romania), Željko Reiner (Croatia), Udo Sechtem (Germany), Per Anton Sirnes (Norway), Michal Tendera (Poland), Adam Torbicki (Poland), Alec Vahanian (France), Stephan Windecker (Switzerland). Document Reviewers: Christian Funck-Brentano (CPG Review Coordinator) (France), Per Anton Sirnes (CPG Review Coordinator) (Norway), Victor Aboyans (France), Eduardo Alegria Ezquerra (Spain), Colin Baigent (UK), Carlos Brotons (Spain), Gunilla Burell (Sweden), Antonio Ceriello (Spain), Johan De Sutter (Belgium), Jaap Deckers (The Netherlands), Stefano Del Prato (Italy), Hans-Christoph Diener (Germany), Donna Fitzsimons (UK), Zlatko Fras (Slovenia), Rainer Hambrecht (Germany), Piotr Jankowski (Poland), Ulrich Keil (Germany), Mike Kirby (UK), Mogens Lytken Larsen (Denmark), Giuseppe Mancia (Italy), Athanasios J. Manolis (Greece), John McMurray (UK), Andrzej Pająk (Poland), Alexander Parkhomenko (Ukraine), Loukianos Rallidis (Greece), Fausto Rigo (Italy), Evangelista Rocha (Portugal), Luis Miguel Ruilope (Spain), Enno van der Velde (The Netherlands), Diego Vanuzzo (Italy), Margus Viigimaa (Estonia), Massimo Volpe (Italy), Olov Wiklund (Sweden), Christian Wolpert (Germany)
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European Society of Cardiology (ESC).
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European Atherosclerosis Society (EAS).
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International Society of Behavioural Medicine (ISBM).
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European Stroke Organisation (ESO).
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European Society of Hypertension (ESH).
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European Association for the Study of Diabetes (EASD).
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European Society of General Practice/Family Medicine (ESGP/FM/WONCA).
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International Diabetes Federation Europe (IDF-Europe).
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European Heart Network (EHN).
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Other ESC entities having participated in the development of this document: Associations: European Association of Echocardiography (EAE), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Heart Rhythm Association (EHRA), Heart Failure Association (HFA)Working Groups: Acute Cardiac Care, e-Cardiology, Cardiovascular Pharmacology and Drug Therapy, Hypertension and the Heart Councils: Basic Cardiovascular Science, Cardiology Practice, Cardiovascular Imaging, Cardiovascular Nursing and Allied Professions, Cardiovascular Primary CareThe content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC.