COMPARISON OF EUROPEAN AND USA GUIDELINES FOR PREVENTION OF CORONARY-HEART-DISEASE

This paper deals with the comparison of European and American guidelines for prevention of CHD, screening and management of hyperlipidemia. The revised EAS guidelines consist of 4 chapters: the scientific basis of CHD prevention; strategies for prevention of CHD; setting up a primary care system for CHD prevention, and the fourth focuses on clinical management with healthy diet, lifestyle and drug treatment of risk factors for CHD. The EAS guidelines emphasize that therapeutic decisions are based on the assessment of the global risk of CHD. In both EAS and American guidelines, optimal total plasma cholesterol and triglyceride target values recommended are < 200 mg/dl for both parameters. Both guidelines state that the initial approach to the treatment of hyperlipidemia should involve diet, increased physical activity, and weight reduction. If target levels are not achieved, the physician should determine whether drug therapy is appropriate. Conservative measures (diet and exercise) are recommended in particular for premenopausal women, elderly subjects and adolescents. There is complete agreement on the importance of secondary prevention of CHD.