Guidelines and global risk: a European perspective
National Heart and Lung Institute, Faculty of Medicine, Imperial College of Science, Technology and Medicine, London, U.K.
* Correspondence: Professor David Wood, Cardiovascular Medicine, National Heart and Lung Institute, Medical Faculty, Imperial College of Science, Technology and Medicine, Charing Cross Campus, Fulham Palace Road, London W6 SRF, U.K.
Abstract
Guidance from the joint European societies on prevention of coronary heart disease (CHD) in clinical practice recommends a common approach to lifestyle and risk factor intervention for patients with established CHD or other atherosclerotic disease, and high-risk persons in the population. Given the biology of atherosclerotic disease and its complications, the distinction between secondary and primary prevention is artificial. A patient with angina may be at lower absolute risk for a major coronary event than is an asymptomatic individual who has multiple risk factors for this disease. The European challenge in primary prevention of CHD is to persuade physicians to manage risk factors such as blood pressure and lipids in the context of absolute or total multifactorial risk. The European Societies recommend targeting individuals with an absolute CHD risk of 20% or more over 10 years for intensive lifestyle intervention and, where necessary, the use of drug therapies to achieve risk factor goals. Use of this total risk approach ensures that treatments are given to those at highest risk and therefore those who are most likely to benefit.
Key Words: Coronary heart disease • European • global risk • guidelines
References
- Sans S, Kesteloot H, Kromhout D, on behalf of the Task Force. The burden of cardiovascular diseases mortality in Europe. Task Force of the European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe. Eur Heart J. 1997;18:1231–1248
- Pyorala K, De Backer G, Graham I, Poole-Wilson PA, Wood D. Prevention of coronary heart disease in clinical practice. Recommendations of the Task Force of the European Society of Cardiology, European Atherosclerotic Society and European Society of Hypertension. Eur Heart J. 1994;15:1300–1331
[Free Full Text] - Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyorala K. Prevention of coronary heart disease in clinical practice. Recommendations of the Second Joint Task Force of European and other Societies on coronary prevention. Eur Heart J. 1998;19:1434–1503
[Free Full Text] - Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497
[Free Full Text] - EUROASPIRE Study Group. Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries. Principal results from EUROASPIRE 11. Euro Heart Survey Programme. Eur Heart J. 2001;22:554–572
[Abstract/Free Full Text] - EUROASPIRE Study Group. Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. Lancet. 2001;357:995–1001[CrossRef][Web of Science][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||