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1、JOINT ESC GUIDELINESEuropean Guidelines on cardiovascular disease prevention in clinical practice (version 2012)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 socie
2、ties and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention 2European Atherosclerosis Society (EAS);3International Society ofBehavioural Medicine (ISBM);4European Stroke Organisation (ESO);5European Society of Hypertension (ESH);6Euro
3、pean 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).- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4、 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - KeywordsCardiovascular disease Prevention Risk assessment Risk management Smoking Nutrition Physi
5、cal activity Psychosocial factorsTable of Contents Abbreviations and acronyms . . . . . . . . . . . . . . . . . . . . . . . .4 1. What is cardiovascular disease prevention? . . . . . . . . . . . . .4 1.1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 1.2 Development of guid
6、elines . . . . . . . . . . . . . . . . . . . .5 1.3 Evaluation methods . . . . . . . . . . . . . . . . . . . . . . . . .5 1.4 Combining evaluation methods . . . . . . . . . . . . . . . . .6 2. Why is prevention of cardiovascular disease needed? . . . . . .7 2.1 Scope of the problem . . . . . . . . .
7、 . . . . . . . . . . . . . .7 2.2 Prevention of cardiovascular disease: a lifelong approach8 2.3 Prevention of cardiovascular disease pays off . . . . . . . .8 2.4 Ample room for improvement . . . . . . . . . . . . . . . . .93. Who should benefit from it? . . . . . . . . . . . . . . . . . . . . . .1
8、0 3.1 Strategies and risk estimation . . . . . . . . . . . . . . . . . .10 3.1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . .10 3.1.2 Strategies. . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 3.1.3 Risk estimation . . . . . . . . . . . . . . . . . . . . . . . . .12
9、3.2 Genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 3.3 Age and gender . . . . . . . . . . . . . . . . . . . . . . . . . . .18 3.4 Psychosocial risk factors . . . . . . . . . . . . . . . . . . . . . .19 3.4.1 Risk factors . . . . . . . . . . . . . . . . . . . . . . . . . .
10、 .19 3.4.2 Clustering of psychosocial risk factors and bio-behavioural mechanisms . . . . . . . . . . . . . . . .20 3.4.3 Assessment of psychosocial risk factors . . . . . . . . .20 3.5 Other biomarkers of risk . . . . . . . . . . . . . . . . . . . . .213.5.1 Inflammatory: high-sensitivity C-reactiv
11、e protein,fibrinogen . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 3.5.2 Thrombotic . . . . . . . . . . . . . . . . . . . . . . . . . . .22 3.6 Imaging methods in cardiovascular disease prevention . .22 3.6.1 Early detection by magnetic resonance imaging of cardiovascular disease in asym
12、ptomatic subjects . . .23 3.6.2 Coronary calcium score . . . . . . . . . . . . . . . . . . .233.6.3 Carotid ultrasound . . . . . . . . . . . . . . . . . . . . . .23 3.6.4 Anklebrachial index . . . . . . . . . . . . . . . . . . . . .24 3.6.5 Ophthalmoscopy . . . . . . . . . . . . . . . . . . . . . .
13、.24 3.7 Other diseases with increased risk for cardiovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .243.7.1 Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 3.7.2 Chronic kidney disease . . . . . . . . . . . . . . . . . . .24 3.7.3 Obstructive
14、sleep apnoea . . . . . . . . . . . . . . . . . .25 3.7.4 Erectile dysfunction . . . . . . . . . . . . . . . . . . . . . .25 3.7.5 Autoimmune diseases . . . . . . . . . . . . . . . . . . . .25 3.7.5.1Psoriasis . . . . . . . . . . . . . . . . . . . . . . .25 3.7.5.2Rheumatoid arthritis . . . . . . . .
15、 . . . . . . .25 3.7.5.3Lupus erythematosus . . . . . . . . . . . . . . .25 3.7.6 Periodontitis . . . . . . . . . . . . . . . . . . . . . . . . . .25 3.7.7 Vascular disease after radiation exposure. . . . . . . .25 3.7.8 Vascular disease after transplantation . . . . . . . . . .25 4. How can cardiov
16、ascular disease prevention be used? . . . . . .26 4.1 Principles of behaviour change . . . . . . . . . . . . . . . . .264.1.1 Introduction: why do individuals find it hard to change their lifestyle? . . . . . . . . . . . . . . . . . . . . . . . . . .26 4.1.2 Effective communication and cognitive-behavioural strategies as a means towards lifestyle change . . . .26 4.1.3 Multimodal, behavioural interventions . . . . . . . . . .27 4.2 Smoking . . . . . . . . . . . . . . . . . . . .
