A comprehensive strategy, focusing on changes in lifestyle and on the management of risk factors, is needed to prevent premature mortality and reduction of life expectancy in good health due to cardiovascular disease (CVD). The European Heart Health Charter has established a roadmap for European countries.

The Joint European Societies' Task Forces on CVD prevention in clinical practice have also developed clear guidelines. These aim to assist physicians and other health professionals to fulfill their role particularly in achieving effective preventative measures in day-to-day clinical practice. Guidelines reflect the consensus arising from a multidisciplinary partnership between the major European scientific societies that are involved in CVD prevention.

The production of evidence-based guidelines on its own is insufficient and needs to be complemented by an implementation program at the European, national and local level. With this in mind, a 'Call for Action' was launched by more than 200 delegates from 46 European countries who attended a European Summit on CVD prevention at the Heart House in 2008. Major achievements have now been accomplished: Guidelines of the 4th Joint European Societies' Task force published in 2007 have been adopted by 24 National Cardiac Societies, translated into 19 languages and published in 19 scientific national journals.

Multidisciplinary implementation alliances have been set up in 24 European countries and another 5 are paving the way for this.

Nationwide prevention strategies have been set up in 17 countries focusing on education regarding balanced diet, physical exercise and avoiding tobacco. Through these approaches, more attention is given to health promotion and CVD prevention within existing health care and insurance systems. This relies on an adequate budget allocated to health education, preventative care and rehabilitation.

Every hospital treating patients with CVD should provide rehabilitation services. These services should be multidisciplinary with particular attention given to: quitting smoking

adequate physical exercise

lifestyle changes and understanding of lifelong multiple drug therapies. The second phase of the implementation program of the Charter and of the Guidelines includes among other: a second European Summit on CVD prevention in 2010

health economic studies of the clinical and cost-effectiveness of CVD prevention

a 'how to' manual to facilitate the implementation of the Guidelines Medical societies have an important role to play in these developments. Much has been achieved over the past decade but the remaining challenges require continuous efforts.

By Professor Guy De Backer

Source:
Jacquelline Partarrieu
European Society of Cardiology