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Focus on National Prevention Strategies: Lithuania

Rokas Navickas, Lithuanian Prevention Group and Rimvydas Slapikas, National CVD Prevention Coordinator in Lithuania

Lithuania is one of the high CVD risk regions in Europe. The mortality due to CVD is 2.5 times higher in comparison to western countries and accounts for 23 thousand deaths every year.

An adequate and timely prevention is needed in order to reduce CVD mortality and morbidity.


In 2005 a Cardiovascular Disease Prevention Program was launched immediately after approval of the Lithuanian Health Ministry.
The main aim of the Program was to reduce the incidence of CVD (myocardial infarction, unstable angina and stroke), its targets were asymptomatic patients having diabetes mellitus and atherosclerosis.

The general practitioner would perform the initial screening. It includes their risk assessment (cholesterol, glucose, arterial blood pressure assessment, weight, physical activity and smoking) and an individualised prevention plan. Patients having a high CVD risk would be referred to specialised cardiovascular disease prevention units.
The Prevention Program involves male aged 40 to 55 and female aged 50 to 65 with no previously diagnosed CVD.
These are people with a known or suspected diabetes mellitus, metabolic syndrome corresponding to 3 or more of the following criteria:

  • Waist circumference ≥ 102 cm in male, ≥ 88 cm in female
  • Triglycerides ≥ 1.7 mmol/L
  • High-density lipoprotein cholesterol < 1.03  mmol/L in male, < 1.29  mmol/L in female
  • Blood pressure (BP) ≥ 130/85 mmHg or treated hypertension
  • Fasting plasma glucose (FPG) ≥ 5.6 mmol/L

All participants undergo a baseline assessment, which includes their medical history, CVD risk profile and lifestyle assessment, evaluation of cardiovascular (CV) family history and physical examination.

Subsequently further investigations are carried out to asses the cardiovascular system:

  • ECG
  • echocardiography
  • exercise tolerance test
  • carotid and peripheral arteries duplex scan
  • arterial function tests
  • blood tests: lipidogram, glucose levels
  • urine tests for microalbuminuria

The Program is carried out by cardiologist who after the assessment of the patient and the performed investigations shape an individualised risk factor adjustment and treatment plan:

  • target  BP <140/90 mmHg
  • introduction to healthy eating habits
  • dyslipidemia management
  • education on healthy physical activity
  • smoking cessation ( dedicated psychological support team)
  • diabetes training scheme for patients with diabetes mellitus introducing patients to diabetes as such, glucose level monitoring and insulin administration

High CVD risk patients are followed up at the CV Prevention Centre every 1-2 years.

For more information, please contact:

Rimvydas Slapikas (email)
National CVD Prevention Coordinator in Lithuania