2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

European Heart Journal, Journal Year: 2021, Volume and Issue: 42(34), P. 3227 - 3337

Published: Aug. 30, 2021

The ESC Guidelines represent the views of and were produced after careful consideration scientific medical knowledge evidence available at time their publication.The is not responsible in event any contradiction, discrepancy and/or ambiguity between other official recommendations or guidelines issued by relevant public health authorities, particular relation to good use healthcare therapeutic strategies.Health professionals are encouraged take fully into account when exercising clinical judgment, as well determination implementation preventive, diagnostic strategies; however, do override, way whatsoever, individual responsibility make appropriate accurate decisions each patient's condition consultation with that patient and, where necessary, caregiver.Nor exempt from taking full updated competent order manage case light scientifically accepted data pursuant respective ethical professional obligations.It also professional's verify applicable rules regulations relating drugs devices prescription.

Language: Английский

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Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel

European Heart Journal, Journal Year: 2020, Volume and Issue: 41(24), P. 2313 - 2330

Published: Jan. 8, 2020

Abstract

Language: Английский

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SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe

European Heart Journal, Journal Year: 2021, Volume and Issue: 42(25), P. 2439 - 2454

Published: May 5, 2021

Abstract Aims The aim of this study was to develop, validate, and illustrate an updated prediction model (SCORE2) estimate 10-year fatal non-fatal cardiovascular disease (CVD) risk in individuals without previous CVD or diabetes aged 40–69 years Europe. Methods results We derived models using individual-participant data from 45 cohorts 13 countries (677 684 individuals, 30 121 events). used sex-specific competing risk-adjusted models, including age, smoking status, systolic blood pressure, total- HDL-cholesterol. defined four regions Europe according country-specific mortality, recalibrating each region expected incidences factor distributions. Region-specific incidence estimated mortality on 10 776 466 individuals. For external validation, we analysed 25 additional 15 European (1 133 181 43 492 After applying the validation cohorts, C-indices ranged 0.67 (0.65–0.68) 0.81 (0.76–0.86). Predicted varied several-fold across regions. example, for a 50-year-old smoker, with pressure 140 mmHg, total cholesterol 5.5 mmol/L, HDL-cholesterol 1.3 5.9% men low-risk 14.0% very high-risk countries, 4.2% women 13.7% countries. Conclusion SCORE2—a new algorithm derived, calibrated, validated predict first-onset populations—enhances identification at higher developing

Language: Английский

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Diretrizes Brasileiras de Hipertensão Arterial – 2020

Arquivos Brasileiros de Cardiologia, Journal Year: 2021, Volume and Issue: 116(3), P. 516 - 658

Published: March 1, 2021

Content 1. Definition, Epidemiology, and Primary Prevention 528 1.1 Definition of Hypertension […] Brazilian Guidelines – 2020

Language: Английский

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2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes

European Heart Journal, Journal Year: 2023, Volume and Issue: 44(39), P. 4043 - 4140

Published: Aug. 25, 2023

The ESC Guidelines represent the views of and were produced after careful consideration scientific medical knowledge evidence available at time their publication.The is not responsible in event any contradiction, discrepancy, and/or ambiguity between other official recommendations or guidelines issued by relevant public health authorities, particular relation to good use healthcare therapeutic strategies.Health professionals are encouraged take fully into account when exercising clinical judgment, as well determination implementation preventive, diagnostic strategies; however, do override, way whatsoever, individual responsibility make appropriate accurate decisions each patient's condition consultation with that patient and, where necessary, caregiver.Nor exempt from taking full updated competent order manage case light scientifically accepted data pursuant respective ethical professional obligations.It also professional's verify applicable rules regulations relating drugs devices prescription.

Language: Английский

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Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement

European Heart Journal, Journal Year: 2022, Volume and Issue: 43(39), P. 3925 - 3946

Published: Aug. 18, 2022

This 2022 European Atherosclerosis Society lipoprotein(a) [Lp(a)] consensus statement updates evidence for the role of Lp(a) in atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis, provides clinical guidance testing treating elevated levels, considers its inclusion global risk estimation. Epidemiologic genetic studies involving hundreds thousands individuals strongly support a causal continuous association between concentration outcomes different ethnicities; is factor even at very low levels low-density lipoprotein cholesterol. High associated with both microcalcification macrocalcification valve. Current findings do not as venous thrombotic events impaired fibrinolysis. Very may associate increased diabetes mellitus meriting further study. has pro-inflammatory pro-atherosclerotic properties, which partly relate to oxidized phospholipids carried by Lp(a). panel recommends least once adults; cascade potential value familial hypercholesterolaemia, or family personal history (very) high premature ASCVD. Without specific Lp(a)-lowering therapies, early intensive management recommended, targeted according level. Lipoprotein apheresis an option progressive despite optimal factors. In conclusion, this reinforces outcomes. Trials treatments are critical confirm benefit stenosis.

Language: Английский

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Evaluating the relationship between circulating lipoprotein lipids and apolipoproteins with risk of coronary heart disease: A multivariable Mendelian randomisation analysis

PLoS Medicine, Journal Year: 2020, Volume and Issue: 17(3), P. e1003062 - e1003062

Published: March 23, 2020

Background Circulating lipoprotein lipids cause coronary heart disease (CHD). However, the precise way in which one or more lipid-related entities account for this relationship remains unclear. Using genetic instruments lipid traits implemented through multivariable Mendelian randomisation (MR), we sought to compare their causal roles aetiology of CHD. Methods and findings We conducted a genome-wide association study (GWAS) circulating non-fasted UK Biobank (UKBB) low-density (LDL) cholesterol, triglycerides, apolipoprotein B identify lipid-associated single nucleotide polymorphisms (SNPs). data from CARDIoGRAMplusC4D CHD (consisting 60,801 cases 123,504 controls), performed univariable MR analyses. Similar GWAS analyses were high-density (HDL) cholesterol A-I. The apolipoproteins UKBB included between 393,193 441,016 individuals whom mean age was 56.9 y (range 39–73 y) 54.2% women. (standard deviation) concentrations LDL 3.57 (0.87) mmol/L HDL 1.45 (0.38) mmol/L, median triglycerides 1.50 (IQR = 1.11) mmol/L. values A-I 1.03 (0.24) g/L 1.54 (0.27) g/L, respectively. identified multiple independent SNPs associated at P < 5 × 10−8 (220), (n 255), (440), (534), (440). Between 56%–93% each trait had not been previously reported large-scale GWASs. Almost half (46%) these with than trait. Assessed individually using MR, (odds ratio [OR] 1.66 per 1-standard-deviation–higher trait; 95% CI: 1.49–1.86; 0.001), (OR 1.34; 1.25–1.44; 0.001) 1.73; 1.56–1.91; effect estimates consistent higher risk In only 1.92; 1.31–2.81; retained robust effect, estimate 0.85; 0.57–1.27; 0.44) reversing that 1.12; 1.02–1.23; 0.01) becoming weaker. Individual showed 0.80; 0.75–0.86; 0.83; 0.77–0.89; lower CHD, but attenuated substantially null on accounting B. A limitation is that, owing nature metabolism, measures related composition particles are highly correlated, creating challenge making exclusive interpretations causation individual components. Conclusions These suggest predominant accounts aetiological

Language: Английский

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2020 International Society of Hypertension global hypertension practice guidelines

Journal of Hypertension, Journal Year: 2020, Volume and Issue: 38(6), P. 982 - 1004

Published: May 6, 2020

Document reviewers: Hind Beheiry (Sudan), Irina Chazova (Russia), Albertino Damasceno (Mozambique), Anna Dominiczak (UK), Anastase Dzudie (Cameroon), Stephen Harrap (Australia), Hiroshi Itoh (Japan), Tazeen Jafar (Singapore), Marc Jaffe (USA), Patricio Jaramillo-Lopez (Colombia), Kazuomi Kario Giuseppe Mancia (Italy), Ana Mocumbi Sanjeevi N.Narasingan (India), Elijah Ogola (Kenya), Srinath Reddy Ernesto Schiffrin (Canada), Ann Soenarta (Indonesia), Rhian Touyz Yudah Turana Michael Weber Paul Whelton Xin Hua Zhang, Yuqing Zhang (China).

Language: Английский

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Inflammation and atherosclerosis: signaling pathways and therapeutic intervention

Signal Transduction and Targeted Therapy, Journal Year: 2022, Volume and Issue: 7(1)

Published: April 22, 2022

Atherosclerosis is a chronic inflammatory vascular disease driven by traditional and nontraditional risk factors. Genome-wide association combined with clonal lineage tracing clinical trials have demonstrated that innate adaptive immune responses can promote or quell atherosclerosis. Several signaling pathways, are associated the response, been implicated within atherosclerosis such as NLRP3 inflammasome, toll-like receptors, proprotein convertase subtilisin/kexin type 9, Notch Wnt which of importance for development regression. Targeting especially inflammasome pathway its regulated cytokine interleukin-1β, could represent an attractive new route treatment atherosclerotic diseases. Herein, we summarize knowledge on cellular participants key pathways in atherosclerosis, discuss preclinical studies targeting these going to target some processes, effects quelling inflammation clinic.

Language: Английский

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Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies—a consensus statement from the European Atherosclerosis Society

European Heart Journal, Journal Year: 2021, Volume and Issue: 42(47), P. 4791 - 4806

Published: July 30, 2021

Recent advances in human genetics, together with a large body of epidemiologic, preclinical, and clinical trial results, provide strong support for causal association between triglycerides (TG), TG-rich lipoproteins (TRL), TRL remnants, increased risk myocardial infarction, ischaemic stroke, aortic valve stenosis. These data also indicate that their remnants may contribute significantly to residual cardiovascular patients on optimized low-density lipoprotein (LDL)-lowering therapy. This statement critically appraises current understanding the structure, function, metabolism TRL, pathophysiological role atherosclerotic disease (ASCVD). Key points are (i) working definition normo- hypertriglyceridaemic states relation ASCVD, (ii) conceptual framework generation due dysregulation production, lipolysis, remodelling, as well clearance remnant from circulation, (iii) pleiotropic proatherogenic actions at arterial wall, (iv) challenges defining, quantitating, assessing atherogenic properties particles, (v) exploration relative atherogenicity compared LDL. Assessment these issues provides foundation evaluating approaches effectively reduce levels by targeting either or hepatic clearance, combination mechanisms. consensus updates an integrated manner, thereby providing platform new therapeutic paradigms aim reducing ASCVD.

Language: Английский

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