Elsevier

Atherosclerosis

Volume 223, Issue 1, July 2012, Pages 1-68
Atherosclerosis

Review
European 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),☆☆

Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)
https://doi.org/10.1016/j.atherosclerosis.2012.05.007Get rights and content

Section snippets

Why is prevention of cardiovascular disease needed?

Key messages

  • Atherosclerotic CVD, especially CHD, remains the leading cause of premature death worldwide.

  • 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.

  • CVD mortality is changing, with declining age-standardized rates in most European countries, which remain high in Eastern Europe.

  • 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.

  1. In apparently healthy persons, CVD risk is most frequently the result of multiple interacting risk factors.

  2. A risk estimation system such as SCORE can assist in making logical management decisions, and may help to avoid both under-and overtreatment.

  3. Certain individuals are at high CVD risk without needing risk scoring and require immediate intervention for all risk factors.

  4. 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

  • 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

  • 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

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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

    ☆☆

    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)

    1

    European Society of Cardiology (ESC).

    2

    European Atherosclerosis Society (EAS).

    3

    International Society of Behavioural Medicine (ISBM).

    4

    European Stroke Organisation (ESO).

    5

    European Society of Hypertension (ESH).

    6

    European Association for the Study of Diabetes (EASD).

    7

    European Society of General Practice/Family Medicine (ESGP/FM/WONCA).

    8

    International Diabetes Federation Europe (IDF-Europe).

    9

    European Heart Network (EHN).

    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.

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