Thomas A. Pearson, MD, MPH, PhD		Laurie Kopin, RN, MS, ANP

Guidelines for Cardiovascular Risk Reduction

Thomas A. Pearson, MD, MPH, PhD
Laurie Kopin, RN, MS, ANP

The Strong Preventive Cardiology Program
University of Rochester Medical Center
Rochester, New York

An increasingly important component of high-quality healthcare is the use of clinical practice guidelines to assist the clinician in providing evidence-based care.

Guidelines constitute the means by which the science base is translated into practice (See Figure). Basic science research, epidemiologic studies, clinical trials, and economic analyses all contribute to reformulation of guidelines and serve as the way that all the evidence can be filtered and integrated into practical recommendations. Moreover, guidelines then can serve as criteria for high-quality healthcare, which in turn can be used to assess a provider’s practice for the purpose of feedback, and for studies of barriers that cause gaps between recommended and actual practice. The identification and correction of these barriers serve as a quality improvement feedback loop.

Evidence-based medicine requires the consideration and application of the best available knowledge to the practice of medicine. This is not synonymous with clinical trials, but with the best research on basic mechanisms of disease and on epidemiologic studies as well. These data are then classified as to the strength of the findings, and are based on levels of evidence (see Table). Generally, Class I or Class IIa, with levels of evidence A and B, constitute the evidence required to recommend a clinical guideline.

This collection of guidelines is designed to assist the busy clinician in the practice of evidence-based cardiovascular risk-reduction and preventive cardiology. This module includes 17 current guidelines relevant to this goal. The module begins with the Framingham risk scoring system used by the National Cholesterol Education Program Adult Treatment Panel III guidelines. The next segments deal with more general, multiple-risk factor guidelines on primary prevention, and in special populations such as women and children. Individual risk-factor guidelines (eg, blood pressure, tobacco, etc) are described. Finally, guidelines for improving cardiovascular health at the community level are provided as a challenge to the clinician to become involved in his/her community. Note that where possible, the guidelines have been updated with the latest information available (eg, specifics from JNC 7). Each guideline is presented in the form of a summary table or illustration.

It is hoped that this collection of cardiovascular risk factor guidelines in one website may be useful to the busy clinician who otherwise would need to search multiple other websites or publications. In this way, access to these up-to-date recommendations will serve to attain our goal of improving the practice of preventive cardiology.


Thomas A. Pearson, MD, MPH, PhD
Albert D. Kaiser Professor and Chair
Department of Community
and Preventive Medicine
Senior Associate Dean of Clinical Research
University of Rochester School of Medicine
Rochester, New York


Laurie A. Kopin, RN, MS, ANP
Senior Nurse Manager/Nurse Practitioner
Strong Heart Center–Cardiac Rehabilitation and Preventive Cardiology Program
University of Rochester Medical Center
Rochester, New York