Cardiovascular Prevention in Clinical Practice (ESC and German Guidelines 2007)

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Abstract
Preventive efforts should be guided by the patient’s global cardiovascular (CV) risk. A risk stratification should be done in every person > age 35 with more than a single risk factor. Recommendations for improved lifestyle are applicable to all persons with CV risk factors: smoking cessation, daily exercise, normal body mass index, Mediterranean diet, blood pressure < 140 mmHg systolic, and LDL cholesterol < 130 mg/dl are beneficial. If the 10-year risk is ≥ 20% for CV events or ≥ 5% for CV death, additional drug interventions are usually necessary: acetylsalicylic acid 100 mg daily, statins to lower LDL cholesterol to < 100 mg/dl or, in diabetics with coronary artery disease, to < 70 mg/dl, blood pressure should be < 130 mmHg systolic, e.g., in patients with diabetes or renal disease. After bare-metal stent implantation clopidogrel should be given for ≥ 4 weeks and after drug-eluting stents for ≥ 6 months. In patients after myocardial infarction with an ejection fraction of < 40%, ACE inhibitors and β-blocker should be started. Influenza vaccination improves prognosis in high-risk patients.