Comparison of American and European Guidelines for Primary Prevention of Cardiovascular Disease

This review compares the primary prevention recommendations of the recent 2021 European Society of Cardiology (ESC) and 2019 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on cardiovascular disease (CVD) prevention. Although the 2019 ACC/AHA guideline represents its...

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Published inJournal of the American College of Cardiology Vol. 79; no. 13; pp. 1304 - 1313
Main Authors Fegers-Wustrow, Isabel, Gianos, Eugenia, Halle, Martin, Yang, Eugene
Format Journal Article
LanguageEnglish
Published Elsevier Inc 01.04.2022
Subjects
guidelines
primary prevention
recommendations
secondary prevention
ACC
secondary prevention
ASCVD
LDL-C
DM
recommendations
BP
CVD
SCORE2-OP
PCE
ESC
SCORE2
primary prevention
guidelines
AHA
CKD
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Summary:This review compares the primary prevention recommendations of the recent 2021 European Society of Cardiology (ESC) and 2019 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on cardiovascular disease (CVD) prevention. Although the 2019 ACC/AHA guideline represents its inaugural version, the ESC guideline is an update to its 2016 statement. Both guidelines address prevention using a holistic approach and agree on the importance of lifestyle optimization and intensified risk factor management. Cardiovascular (CV) risk assessment tools differ, reflecting the unique populations being screened as well as philosophical differences to their approach. Conventional risk factors are used to estimate CV risk, but each guideline acknowledges the role of risk modifiers to refine risk calculation. The ESC guideline recognizes the importance of nonclassical risk factors, including environmental issues, that impact CV health at the population level and calls for legislative action at the local, regional, and national levels. [Display omitted] •The 2021 ESC primary prevention guidelines estimate atherosclerotic risk using the SCORE2/SCORE2-OP calculators, whereas the ACC/AHA guidelines recommend the PCE.•Both guidelines highlight aggressive risk factor management and lifestyle modifications.•The ESC guidelines incorporate nonclassical risk factors to optimize risk reduction at the population level.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2022.02.001