2012 年欧洲心血管疾病临床实践、预防指南

Atherosclerotic cardiovascular disease (CVD) is a chronic disorder developing insidiously throughout life and usually progressing to an advanced stage by the time symptoms occur. It remains the major cause of premature death in Europe, even though CVD mortality has fallen considerably over recent decades in many European countries. It is estimated that >80% of all CVD mortality now occurs in developing countries. CVD causes mass disability: within the coming decades the disability-adjusted life years (DALYs) estimate is expected to rise from a loss of 85 million DALYs in 1990 to a loss of w150 million DALYs globally in 2020, thereby remaining the leading somatic cause of loss of productivity.

CVD is strongly connected to lifestyle, especially the use of tobacco, unhealthy diet habits, physical inactivity, and psychosocial stress. The World Health Organization (WHO) has stated that over three-quarters of all CVD mortality may be prevented with adequate changes in lifestyle. CVD prevention, remaining a major challenge for the general population, politicians, and healthcare workers alike, is defined as a co-ordinated set of actions, at public and individual level, aimed at eradicating, eliminating, or minimizing the impact of CVDs and their related disability. The bases of prevention are rooted in cardiovascular epidemiology and evidence-based medicine.

The aim of the 2012 guidelines from the Fifth Joint Task Force (JTF) of the European Societies on Cardiovascular Disease Prevention in Clinical Practice is to give an update of the present knowledge in preventive cardiology for physicians and other health workers. The document differs from 2007 guidelines in several ways: there is a greater focus on new scientific knowledge. The use of grading systems [European Society of Cardiology (ESC) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE)] allows more evidence-based recommendations to be adapted to the needs of clinical practice.