2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies. With the special contribution of the European Association of Preventive Cardiology (EAPC)

Frank L J Visseren, François Mach, Yvo M Smulders, et al.


European Heart Journal August 2021; ehab484.

First published: August 30, 2021  DOI: 10.1093/eurheartj/ehab484



Prior to the current guideline, the last time the ESC published guidance on cardiovascular disease (CVD) prevention was in 2016. As a result, the new guidelines provide an extensive update on a variety of key developments and new evidence intended to assist healthcare professionals in reducing the burden of ASCVD in both individual patients, as well as at a population level. In particular, updated information is provided on ASCVD risk classification and subsequent prevention strategies to support shared decision-making by the patient and their healthcare professional; and an updated estimation of CVD risk in apparently healthy subjects, and also older persons and in patients with established ASCVD or diabetes mellitus.

As well as providing the tools to estimate an individual’s CVD risk, the updated guidance also outlines a variety of stepwise approaches intended to individualise a patient’s treatment goals. This is to take into account the diversity in CVD patients, rather than a one-size-fits-all prevention strategy. New evidence is also presented on antithrombotic treatment regimens for ASCVD prevention, split via sex-specific aspects. As a note: the targets for LDL-C, blood pressure and glycaemic control in patients with diabetes mellitus is unchanged and remains as recommended in recent European Society of Cardiology Guidelines on diabetes, pre-diabetes, and cardiovascular diseases.

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