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Document Details :
Title: Aanbevelingen voor de preventie van cardiovasculaire aandoeningen in de klinische praktijk. Belgische Nationale Werkgroep voor de Preventie van Hart- en Vaatziekten
Author(s): DE BACKER G, DE BACQUER D, BROHET C, DE CEUKELIER S, FRANCK A, KRZENTOWSKI G, LEGAT P, POCHET JM, SCHEEN A
Journal: Tijdschrift voor Geneeskunde
Volume: 61 Issue: 8 Date: 2005
Guidelines on cardiovascular disease prevention in clinical practice
A Joint Task Force was constituted in Belgium to adapt the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice, developed by the Third Joint Task Force of European and other Societies.
The objectives of these guidelines are to reduce the incidence of first or recurrent clinical events due to coronary heart disease, ischaemic stroke and peripheral artery disease. The focus is prevention of disability and early deaths. To this end, the current guidelines address the role of lifestyle changes, the management of major cardiovascular risk factors and the use of different prophylactic drug therapies in the prevention of clinical CVD.
These new guidelines differ from the previous ones in several aspects:
1. From coronary heart disease (CHD) to CVD prevention, the aetiology of myocardial infarction, ischaemic stroke and peripheral arterial disease is similar and, indeed, recent intervention trials have shown that several forms of therapy prevent not only coronary events and revascularisations but also ischaemic stroke and peripheral artery disease. Therefore these new guidelines are dealing with CVD prevention, not merely coronary heart disease.
2. In order to assess the risk for development of CVD different multifactorial risk models have been proposed. The Task Force recommends using the SCORE model calibrated for Belgium and these charts are present.
3. Explicit clinical priorities. The first priority of practitioners are patients with established CVD and subjects who are at high risk of developing CVD. Subjects at high risk may also be recognized by new imaging techniques which allow visualisation of subclinical atherosclerosis.
4. Updated recommendations are given regarding behavioural changes, risk factor management and the prophylactic use of certain drugs. This includes a more professional management of behavioural risk factors for which the goals remain similar: no smoking, making healthy food choices and being physically active. Goals are set for blood pressure, total and LDL cholesterol as well as for good glycaemic control.