Samenvatting van de multidisciplinaire richtlijn ‘Cardiovasculair risicomanagement’ (herziening 2011)

The first revision of the Dutch Multidisciplinary Guideline on Cardiovascular Risk Management has recently been published. The most important elements are:

Conflict of interest: Prof. Dr. Y.M. Smulders has received remuneration for developing educative presentations; the VUMC, where he is employed, has received various research grants. Dr K.T.S. Konings has received financial compensation from Maastricht University and the SBOH (educational organisation for physicians) for consultancy, from the Stichting Regionale Huisartsenzorg Maastricht Heuvelland (RHZ) (GP association in Maastricht and surrounding area) for lecturing and from Maastricht University, SBOH, RHZ, Health Investment and Zorggroep (healthcare group) Almere for developing educative presentations. Prof. Dr. C.D.A. Stehouwer conducted scientific research between 2005-2012 that was financially supported by Astra-Zeneca, GSK, MSD and Pfizer. Financial support: none declared.

• The decision whether to treat individuals not previously known to have cardiovascular disease is based on a new risk table in which Dutch research data on morbidity have been incorporated.

• An explanation of the roles of additional risk factors ignored in the cardiovascular risk function, such as a sedentary lifestyle and a high BMI, is provided.

• A method for estimating the cardiovascular risk in patients with diabetes mellitus and rheumatoid arthritis has been developed.

• New recommendations concerning the measurement of blood pressure at home and in the ambulatory setting have been formulated.

• The recommendations for the choice of antihypertensive drugs have been revised.

• The recommendations on handling therapy-resistant hypertension are provided.

• Recommendations for choosing statins based on a current cost-effectiveness analysis are provided.