European Heart Journal Advance Access originally published online on August 28, 2007
European Heart Journal 2007 28(19):2375-2414; doi:10.1093/eurheartj/ehm316
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
European guidelines on cardiovascular disease prevention in clinical practice: executive summary,
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)
Authors/Task Force Members,
Oslo (Norway)
Gentofte (Denmark)
Copenhagen (Denmark)
Uppsala (Sweden)
Praha (Czech Republic)
Lille (France)
Gent (Belgium)
London (UK)
Oslo (Norway)
Marburg (Germany)
Utrecht (The Netherlands)
London (UK)
London (UK)
Oskarshamn (Sweden)
Pavia (Italy)
Kuopio (Finland)
Zagreb (Croatia)
Madrid (Spain)
Barcelona (Spain)
Rotterdam (The Netherlands)
London (UK)
London (UK)
Belfast (UK)
Madrid (Spain)
Other experts who contributed to parts of the guidelines:,
Schoonhoven (The Netherlands)
Dublin (Ireland)
Dublin (Ireland)
Dublin (Ireland)
European Society of Cardiology (ESC) Committee for Practice Guidelines (CPG):,
(France)
(UK)
(Italy)
(France)
(Norway)
(France)
(Greece)
(The Netherlands)
(Denmark)
(France)
(Germany)
(Germany)
(Poland)
(Czech Republic)
(Spain)
Document reviewers:,
(The Netherlands)
(Germany)
(Italy)
(UK)
(Belgium)
(Italy)
(UK)
(Sweden)
(Norway)
(Denmark)
(Italy)
(Greece)
(Sweden)
(Norway)
(UK)
(Sweden)
(Malta)
(USA)
(The Netherlands)
(Turkey)
(Sweden)
(Greece)
1 European Society of Cardiology (ESC) including European Association for Cardiovascular Prevention and Rehabilitation (EACPR) and Council on Cardiovascular Nursing,
2 European Association for the Study of Diabetes (EASD),
3 International Diabetes Federation Europe (IDF-Europe),
4 European Stroke Initiative (EUSI),
5 International Society of Behavioural Medicine (ISBM),
6 European Society of Hypertension (ESH),
7 European Society of General Practice/Family Medicine (ESGP/FM/WONCA),
8 European Heart Network (EHN),
9 European Atherosclerosis Society (EAS).
* Corresponding author. Department of Cardiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland, Tel: +353 1 414 4105; fax: +353 1 414 3052; e-mail: ian.graham@amnch.ie
The 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.
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, over-ride the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patients, in consultation with that patient, and, where
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Preamble |
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Introduction |
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The scope of the problem: past and future |
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Scientific background
Practical aspects: coronary artery disease
Heart failure
Aortic aneurysm and dissection
Peripheral arterial disease
Stroke
Practical aspects: prevention and management of stroke
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Prevention strategies and policy issues |
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Scientific background
Practical aspects: policy issues
Prevention in clinical practice
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How to evaluate scientific evidence |
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Scientific background
What is ‘evidence’?
Grading of evidence
The problems of evidence and guidance
Practical aspects
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Priorities, total risk estimation, and objectives |
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Introduction
Priorities
Total risk estimation
How do I assess risk?
Conclusions
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Principles of behaviour change and management of behavioural risk factors |
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Scientific background
The physician/caregiver–patient interaction as a means towards behavioural change
Specialized and multimodal interventions
Practical aspects: management of behavioural risk factors
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Smoking |
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Scientific background
Practical aspects: prevention and management of smoking
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Nutrition |
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Scientific background
Practical aspects: management
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Overweight and obesity |
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Scientific background
Body weight and risk
Which index of obesity is the best predictor of cardiovascular risk and cardiovascular risk factors—body mass index (BMI), waist circumference (WC), or waist–hip circumference ratio (WHR)?
Imaging and fat distribution
Practical aspects: management of obesity and overweight
Physical activity and body weight
Diet and behavioural interventions
Drug treatment of overweight
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Physical activity |
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Scientific background
Estimating physical activity
Practical aspects: management
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Heart rate |
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Scientific background
Practical aspects: management
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Blood pressure |
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Scientific background
Risk stratification and target organ damage
Practical aspects: management of hypertension
Who to treat?
How to treat?
Antihypertensive drugs
Desirable blood pressure
Duration of treatment
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Plasma lipids |
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Scientific background
Practical aspects: management
Should statins be given to all persons with cardiovascular disease?
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Diabetes |
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Scientific background
Practical aspects: management
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The metabolic syndrome |
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Scientific background
Practical aspects: management
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Psychosocial factors |
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Scientific background
Practical aspects: management of psychosocial risk factors in clinical practice
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Inflammation markers and haemostatic factors |
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Scientific background
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Genetic factors |
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Family history: scientific background
Family history: practical aspects
Phenotypes: scientific background
Genotypes: scientific background
DNA-based tests for risk prediction
Practical aspects
DNA-based tests for risk prediction
Pharmacogenetics
Severe familial dyslipidaemias and coronary heart disease
Familial hypercholesterolaemia (FH)
Familial combined hyperlipidaemia (FCH)
Familial high-density lipoprotein deficiency syndromes
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New imaging methods to detect asymptomatic individuals at high risk for cardiovascular events |
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Scientific background
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Gender issues: cardiovascular disease prevention in women |
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Scientific background
Practical aspects
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Renal impairment as a risk factor in cardiovascular disease prevention |
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Scientific background
Practical aspects: management
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Cardioprotective drug therapy |
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Scientific background
Antiplatelet therapies
ß-Blockers
ACE inhibitors
Anticoagulation
Practical aspects: management
Antiplatelet therapy: aspirin
Antiplatelet therapy: clopidogrel
ß-Blockers
ACE inhibitors
Calcium channel blockers
Diuretics
Anticoagulation
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Implementation strategies |
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Scientific background
Barriers to the implementation of guidelines
Doctor–patient relationship
Practical aspects
Important arenas for training
Implementation strategies
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Footnotes |
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References |
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