Guidelines on cardiovascular disease prevention in clinical practice: the European perspective

To summarize the recommendations of the Third Joint European Society's Task Force on Cardiovascular Disease Prevention in Clinical Practice so that these may be made accessible to a wider audience.

The relative importance of population and high-risk strategies for cardiovascular disease prevention is summarized. The guidelines stress the primacy of total risk assessment to guide management decisions. The hazards of decisions based on assessment of single risk factors is illustrated. Compared with earlier guidelines, the focus has changed from coronary heart disease to total cardiovascular disease prevention. A new system for predicting total cardiovascular disease mortality risk (Systematic Coronary Risk Evaluation) is presented. Explicit clinical priorities are defined.

Total cardiovascular risk should be assessed before making management decisions. Individuals with established cardiovascular disease and those with high total cardiovascular risk gain most from preventive advice. This high-risk approach should be complemented by a population-based preventive strategy.