Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

    We have a manual that explains all the features 

Record number 425263
Title Cardiovascular risk management of hypertension and hypercholestrolaemia in the Netherlands: from unifactorial to multifactorial approach
Author(s) Dis, I. van; Geleijnse, J.M.; Verschuren, W.M.M.; Kromhout, D.
Source Netherlands Heart Journal 20 (2012)7-8. - ISSN 1568-5888 - p. 320 - 325.
DOI http://dx.doi.org/10.1007/s12471-012-0268-8
Department(s) Chair Nutrition and Disease
VLAG
Publication type Refereed Article in a scientific journal
Publication year 2012
Keyword(s) coronary-heart-disease - clinical-practice - cholesterol concentrations - european guidelines - randomized-trials - serum-cholesterol - task-force - prevention - society - atherosclerosis
Abstract About 30 years ago, the first Dutch unifactorial guidelines on hypertension and hypercholesterolaemia were developed. These guidelines have been revised several times, often after publication of landmark studies on new generations of drugs. In 1978, cut-off points for pharmacological treatment of hypertension were based on diastolic blood pressure values =115 mmHg, and in 2000 they were lowered to >100 mmHg. From 1997 onwards, cut-off points for systolic blood pressure values >180 mmHg were introduced, which became leading. In 1987, cut-offs for hypercholesterolaemia of =8 mmol/l were set and from 2006 pharmacological treatment was based on a total/HDL cholesterol ratio >8. Around 2000, treatment decisions for hypertension and/or hypercholesterolaemia were no longer based on high levels of individual risk factors, but on a multifactorial approach based on total risk of cardiovascular diseases (CVD), determined by a risk function. In the 2006 multidisciplinary guideline on cardiovascular risk management, the Framingham risk tables were replaced by European SCORE risk charts. A cut-off point of 10% CVD mortality was set in the Netherlands. In 2011, this cut-off point changed to 20% fatal plus nonfatal CVD risk. Nowadays, ‘the lower the risk factors, the lower the absolute risk’ is the leading paradigm in CVD prevention.
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