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Guidelines CVD Prevention Addenda

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European Heart Journal

doi:10.1093/eurheartj/ehs165

JOINT ESC GUIDELINES

European Guidelines on cardiovascular disease


prevention in clinical practice (version 2012):
Addenda
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)
Authors/Task Force Members: Joep Perk (Chairperson) (Sweden)*, Guy De Backer 1
eljko Reiner 2
(Belgium), Helmut Gohlke1 (Germany), Ian Graham 1 (Ireland), Z
(Croatia), W.M. Monique Verschuren1 (The Netherlands), Christian Albus 3
(Germany), Pascale Benlian 1 (France), Gudrun Boysen 4 (Denmark), Renata Cifkova 5
(Czech Republic), Christi Deaton 1 (UK), Shah Ebrahim 1 (UK), Miles Fisher 6 (UK),
Giuseppe Germano 1 (Italy), Richard Hobbs 1,7 (UK), Arno Hoes 7 (The Netherlands),
Sehnaz Karadeniz 8 (Turkey), Alessandro Mezzani 1 (Italy), Eva Prescott 1 (Denmark),
Lars Ryden1 (Sweden), Martin Scherer 7 (Germany), Mikko Syvanne9 (Finland),
Wilma J.M. Scholte Op Reimer 1 (The Netherlands), Christiaan Vrints 1 (Belgium),
David Wood 1 (UK), Jose Luis Zamorano1 (Spain), Faiez Zannad 1 (France).
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),
eljko Reiner (Croatia), Udo Sechtem (Germany), Per Anton Sirnes (Norway),
Bogdan A. Popescu (Romania), Z
Michal Tendera (Poland), Adam Torbicki (Poland), Alec Vahanian (France), Stephan Windecker (Switzerland).
* Corresponding author: Joep Perk, School of Health and Caring Sciences, Linnaeus University, Stagneliusgatan 14, SE-391 82 Kalmar, Sweden. Tel: +46 70 3445096, Fax: +46 491
782 643, Email: joep.perk@lnu.se

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 Care
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, 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 patients
guardian or carer. It is also the health professionals 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

& The European Society of Cardiology 2012. All rights reserved. For permissions please email: journals.permissions@oxfordjournals.org

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Joint ESC Guidelines

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 Pajak (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).
Societies: 1European Society of Cardiology (ESC); 2European Atherosclerosis Society (EAS); 3International Society of
Behavioural Medicine (ISBM); 4European Stroke Organisation (ESO); 5European Society of Hypertension (ESH);
6
European Association for the Study of Diabetes (EASD); 7European Society of General Practice/Family Medicine (ESGP/
FM/WONCA); 8International Diabetes Federation Europe (IDF-Europe); 9European Heart Network (EHN).

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Keywords

Cardiovascular disease Prevention Risk assessment Risk management Smoking Nutrition


Physical activity Psychosocial factors

SCORE charts with integrated


HDL-cholesterol values
Tables taken from the ESC Guidelines for the Management of
Dyslipidaemias (European Heart Journal 2011; 32: 17691818doi:10.1093/eurheartj/ehr158 - European Atherosclerosis Society
(EAS). Atherosclerosis 2011; doi:10.1016/j.atherosclerosis.2011.06.012)

http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/
Dyslipidemias.aspx
The use is the same as for the general SCORE charts:

Joint ESC Guidelines

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The chart below shows relative and not absolute risk. Thus a
person in the top right-hand box has a risk that is 12 times
higher than a person in the bottom left. This may be helpful
when advising a young person with a low absolute but high relative
risk of the need for lifestyle change.

Figure 4 Risk function without high-density lipoprotein-cholesterol (HDL-C) for women in populations at high cardiovascular disease risk,
with examples of the corresponding estimated risk when different levels of HDL-C are included.

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Joint ESC Guidelines

Figure 5 Risk function without high-density lipoprotein-cholesterol (HDL-C) for men in populations at high cardiovascular disease risk, with
examples of the corresponding estimated risk when different levels of HDL-C are included.

Joint ESC Guidelines

Figure A

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Figure B

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Figure C

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Figure D

Joint ESC Guidelines

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Figure E

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Figure F

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Figure G

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Figure H

Joint ESC Guidelines

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