Cardiovascular disease prevention: the new Joint British Societies' guidelines.

The Joint British Societies' recommendations for coronary heart disease (CHD) prevention have been updated in the light of recent developments. Key features of the new guidelines include focusing on cardiovascular disease (CVD) prevention rather than CHD and adopting strategies that target high-risk groups, with equal priority being given to all those with established CVD or diabetes mellitus. Subjects without CVD but with a risk factor profile resulting in an absolute risk of developing CVD>or=20% over 10 years should be included in these strategies and CVD prevention should also be applied to subjects with particularly unfavourable single risk factors including familial dyslipidaemias, such as familial hypercholesterolaemia, hypercholesterolaemia when the total cholesterol:HDL cholesterol ratio is >or=7.0, hypertension when the blood pressure (BP)>or=160 mmHg systolic or >or=100 mmHg diastolic or lesser degrees of hypertension when there is end-organ damage. The optimal target for total cholesterol is <4.0 mmol/L and for LDL cholesterol<2.0 mmol/L, or a reduction of 25% in total cholesterol and a 30% reduction in LDL cholesterol, whichever achieves the lower absolute level. The optimal BP target is <140 mmHg systolic and <85 mmHg diastolic pressure with lower targets in subjects with CVD, diabetes or chronic renal failure. If these conditions are present, treatment should aim to achieve <130 mmHg systolic and <80 mmHg diastolic pressures.