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New CVD Prevention Guidelines: Cardiovascular disease mortality ‘could be halved’

Heart Failure Congress News

Massimo Piepoli (Polichirurgico Hospital G. Da Saliceto, Piacenza, Italy) and Arno W. Hoes (University Medical Center Utrecht, The Netherlands)

The new European Guidelines on CVD Prevention 2016. Be the first to know!; Tuesday 24 May, 10:05–11:35; Paris

The first official presentation of the 2016 European Guidelines on CVD Prevention takes place here in Florence at Heart Failure 2016, with the participation of EACPR and representatives from the CVD Prevention Guidelines Task Force.

Mortality rates from cardiovascular disease (CVD) could be halved by small and achievable reductions in risk factors, via a combination of state-of-the-art healthcare and legalisation, experts will say this morning.

In a session dedicated to the new 2016 European Guidelines on CVD Prevention, to be published simultaneously in the European Heart Journal and the European Journal of Preventive Cardiology, the latest advice on the prevention of CVD will be presented, alongside ways to incentivise healthy choices.

The guidelines were developed by a Task Force containing members from the ESC and nine other societies, chaired by Massimo Piepoli (Polichirurgico Hospital G. Da Saliceto, Piacenza, Italy) and Arno Hoes (University Medical Center Utrecht, The Netherlands). They said that there have been reductions in CVD mortality over recent decades due to population reductions in risk factors, primarily cholesterol and blood pressure levels and smoking, and improved treatment of cardiovascular disease.

“This favourable trend is partly offset by an increase in other risk factors, mainly obesity and type 2 diabetes mellitus, and patients’ poor adherence to lifestyle changes,” Prof. Piepoli said. “Moreover, more patients are surviving their first CVD event and they remain at high risk.”

Designed to support healthcare professionals in communicating with individuals about their cardiovascular risk and to provide tools to help promoting population-based strategies, the documents presents a model structured around four core questions on the nature of prevention and who will benefit, and how and where to intervene.

The recommendations focus on vulnerable groups such as the elderly and younger adults, as well as some specific patient groups with rheumatoid arthritis, erectile dysfunction, and those receiving cancer therapies. They also highlight the need for at-risk women to be screened for diabetes and hypertension, and for ethnicity to be considered during CVD risk assessment.

The guidelines draw on the latest scientific evidence, such as the recent IMPROVE-IT and SPRINT trials, and present adapted target levels for risk factors such as blood pressure and lipid levels.

Reducing the population risk of CVD by just 1%, it argues, could result in 25,000 fewer cases from CVD and cost savings of approximately €40 million per year in the average European country.

To achieve that, Prof. Piepoli says that “intensive work” is needed at individual and public health levels, “with life-long measures that hold preventive actions from birth to old age”.

“Thus a strategy for individuals at high risk is, for the first time, complemented by population-level recommendation to encourage a healthy lifestyle and to reduce population levels of risk factors,” he said.

As population-level interventions have been shown to effectively modify individual lifestyles, the document calls for changes to laws and healthcare policies across Europe on key areas such as food, physical activity and smoking. It says, for example, that legislation is needed to reduce the number of calories and levels of salt, saturated fat and sugar in food portions, as well as portion sizes.

The guidelines say that physical activity should be considered in urban planning, and that taxes should incentivise healthy choices. Furthermore, smokeless tobacco should be restricted, and children should be protected from passive smoking, while electronic cigarettes should have the same marketing restrictions as cigarettes.

Secondary prevention measures are also presented for patients with conditions such as atrial fibrillation, coronary artery disease, cerebrovascular disease, peripheral artery disease, chronic heart failure, in whom cardiac rehabilitation is highly recommended.

View the session programme and access the resources on SP&P