Prevenzione Italia 2021

Un update del Documento di consenso
e raccomandazioni per la prevenzione
cardiovascolare in Italia

Documento coordinato da Massimo Volpe

Presidente Società Italiana per la Prevenzione Cardiovascolare (SIPREC)

in collaborazione con:

SIC Società Italiana di Cardiologia

SID Società Italiana di Diabetologia

SIMI Società Italiana di Medicina Interna

SIIA Società Italiana dell’Ipertensione Arteriosa

SISA Società Italiana per lo Studio dell’Aterosclerosi

SIN Società Italiana di Nefrologia

SIO Società Italiana dell’Obesità

SIT Società per la Salute Digitale e la Telemedicina

SINut Società Italiana di Nutraceutica

AICPR Associazione Italiana di Cardiologia Clinica, Preventiva e Riabilitativa

IMSS Istituto di Medicina e Scienza dello Sport – Sport e Salute

SIGG Società Italiana di Gerontologia e Geriatria

CNR Consiglio Nazionale delle Ricerche

FDM Fondazione Dieta Mediterranea

Hanno aderito al documento:

AMD Associazione Medici Diabetologi

FIV Fondazione Italiana Vascolare

SIAPAV Società Italiana di Angiologia e Patologia Vascolare

SIDV Società Italiana di Diagnostica Vascolare

SISET Società Italiana Studio Emostasi e Trombosi

SISMEC Società Italiana di Statistica Medica ed Epidemiologia Clinica

Coordinamento Scientifico

Prof. Massimo Volpe

Cattedra di Cardiologia, Dipartimento di Medicina Clinica e Molecolare, Facoltà di Medicina e Psicologia, Sapienza Università di Roma

U.O.C. Cardiologia, Azienda Ospedaliero-Universitaria Sant’Andrea, Roma

e-mail: massimo.volpe@uniroma1.it

Coordinamento Editoriale

ARISTEA – Via Roma, 10 - 16121 Genova

Tel. 010 553591, Fax 010 5535970

e-mail: genova@aristea.com

www.aristea.com

Assistenza Editoriale

Sig.ra Simona Scalera (Roma)

Consiglio Direttivo SIPREC

Massimo Volpe (Roma), Bruno Trimarco (Napoli), Gaetano Crepaldi (Padova), Simonetta Bellone (Novara), Paolo Bellotti (Savona), Marco Bertolotti (Modena), Alessandro Biffi (Roma), Agostino Consoli (Chieti), Alberto Corsini (Milano), Giovambattista Desideri (L’Aquila), Claudio Ferri (Roma), Maria Grazia Modena (Modena), Giulio Nati (Roma), Matteo Pirro (Perugia), Speranza Rubattu (Roma), Giuliano Tocci (Roma), Saula Vigili de Kreutzenberg (Padova), Roberto Volpe (Roma)

Autori

Allegra Battistoni (Roma), Giovanna Gallo (Roma), Caterina Oriana Aragona (Messina), Fabio Barchiesi (Roma), Alessio Basolo (Pisa), Simonetta Bellone (Novara), Paolo Bellotti (Savona), Marco Bertolotti (Modena), Andrea Bianco (Cagliari), Alessandro Biffi (Roma), Claudio Borghi (Bologna), Arrigo Francesco Giuseppe Cicero (Bologna), Agostino Consoli (Chieti), Alberto Corsini (Milano), Giovambattista Desideri (L’Aquila), Barbara Di Giacinto (Roma), Fredrick Fernando (Roma), Claudio Ferri (L’Aquila), Leonarda Galiuto (Roma), Davide Grassi (L’Aquila), Guido Grassi (Milano), Giancarlo Icardi (Genova), Ciro Indolfi (Catanzaro), Elisa Lodi (Modena), Maria Grazia Modena (Modena), Maria Lorenza Muiesan (Brescia), Giulio Nati (Roma), Andrea Orsi (Genova), Stefano Palermi (Napoli), Gianfranco Parati (Milano), Andrea Passantino (Bari), Alessandra Patelli (Roma), Antonio Pelliccia (Roma), Martino Pengo (Milano), Pasquale Perrone Filardi (Napoli), Gianluca Perseghin (Milano), Matteo Pirro (Perugia), Roberto Pontremoli (Genova), Giuseppe Rengo (Napoli), Roberta Ricotti (Novara), Damiano Rizzoni (Brescia), Bianca Rocca (Roma), Carlo Rotella (Firenze), Speranza Rubattu (Roma), Guido Salvetti (Pisa), Angela Sciacqua (Catanzaro), Andrea Serdoz (Roma), Felice Sirico (Napoli), Maria Rosaria Squeo (Roma), Giuliano Tocci (Roma), Bruno Trimarco (Napoli), Saula Vigili de Kreutzenberg (Padova), Roberto Volpe (Roma), Massimo Volpe (Roma)

Revisori

Francesco Perticone (Catanzaro), Maurizio Averna (Palermo), Carmine Savoia (Roma), Augusto Zaninelli (Firenze)

Prevention Italy 2021

An update of the 2018 Consensus document and recommendations

for the prevention of cardiovascular disease in Italy

Cardiovascular prevention represents one of the most important strategies of public health, since cardiovascular diseases are the first cause of morbidity and mortality worldwide.

Measures to promote a healthy lifestyle and an adequate control of risk factors need be highlighted also during the COVID-19 outbreak, which has dramatically changed the priorities and the use of available resources by the National Health Systems. Indeed, the COVID-19 pandemic and the consequent lockdown measures imposed in several countries have caused a widespread diffusion of behaviors with detrimental effects on the cardiovascular system, including inappropriate dietary habits, sedentary lifestyle and smoking. Moreover, as a consequence of the COVID-19 outbreak, a relevant number of programmed follow-up visits and screening procedures have been cancelled, and hospital admissions for severe acute pathologies, such as myocardial infarction, have been significantly reduced, with a parallel increase in fatality and complication rates. This represents a serious social issue, whose impact will last for many years, and which deserves priority attention by the scientific and healthcare communities. In such a context, cardiovascular prevention may play a key role in interrupting this vicious circle.

The aim of this update of the 2018 SIPREC consensus document is to analyze and highlight the available evidence produced by medical research over the last 3 years, providing with the synergistic contribution of many scientific societies an integrated tool to support clinical practice. Indeed, important new recommendations have been introduced in the management of hypertension, dyslipidemias and type 2 diabetes, consisting in the identification of lower therapeutic targets, the promotion of combination strategies and the introduction in routine clinical practice of new effective pharmacological classes, such as sodium-glucose cotransporter-2 inhibitors for the treatment of diabetes and heart failure and proprotein convertase subtilisin/kexin type 9 inhibitors for hypercholesterolemia. Moreover, new evidence has become available for the management of antiplatelet therapy, both in primary and secondary prevention.

Finally, much attention has been devoted to telemedicine, which has shown great promise to support cardiovascular prevention and care not only during the COVID-19 pandemic but also as part of routine care in the future.

Key words. Cardiovascular disease; Multidisciplinary approach; Prevention; Risk factors.