Assessment

European guidelines

2007 European Guidelines:
The prevention of cardiovascular events in patients with established CHD or other atherosclerotic disease, and in asymptomatic individuals at high risk, should be guided in accordance with overall cardiovascular risk. Most recently, the Fourth Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice has provided guidelines using a simplified risk analysis chart, the SCORE (Systemic Coronary Risk Evaluation) system, which includes additional risk factors such as age, gender, smoking, total cholesterol or the total cholesterol/HDL ratio and systolic blood pressure. There are now two charts, a low-risk chart used in Belgium, France, Greece, Italy, Luxembourg, Spain, Switzerland and Portugal and a high-risk chart used in all other European countries. The SCORE system provides a risk assessment for the probability of a fatal cardiovascular event over 10 years.¹

With respect to blood lipids, treatment is recommended to achieve total cholesterol consistently below 5.0 mmol/L (190 mg/dL) and an LDL-C below 3.0 mmol/L (115 mg/dL). For patients with clinically established CVD and patients with diabetes, treatment should achieve lower levels: total cholesterol <4.5 mmol/L (175 mg/dL) and LDL-C
<2.5 mmol/L (100 mg/dL). If lifestyle changes fail to reach these levels, cholesterol-lowering therapy should be initiated. An optimal target of 2.0 mmol/L (77 mg/dL) has been defined for high risk patients if feasible clinically and in terms of local financial resources.¹

Reference:
1. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice. Eur J Cardiovasc Prev Rehab 2007; 14: E1-E40.