Implementation of Cardiovascular Disease Prevention Guidelines in Clinical Practice-Can We Do Better?

OPINION STATEMENT: Passive dissemination of guidelines in isolation is generally ineffective and results in only small changes in practice. The challenge is to motivate and support more physicians to routinely practice cardiovascular prevention. There is considerable potential to raise the standard of cardiovascular prevention through more effective lifestyle intervention, control of other risk factors and appropriate use of cardioprotective medication. A more comprehensive multidisciplinary and professional approach accessible to both patients with established disease as well as those who are at high risk of developing CVD and provided in each country by existing or adapted 'prevention centres' is needed. Cardiovascular prevention requires an integrated family-based approach, involving multidisciplinary teams of health care professionals, adapted to medical and cultural settings in each country in order to achieve better lifestyles, risk factor control and adherence with cardioprotective medications in our patients with coronary disease and to reduce their risk of recurrent cardiovascular events and improve quality of life and survival. Coronary intervention should always be followed by prevention.