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Table 3 Continued

New or revised Recommendations in 2013 version Class Recommendations in 2021 version Class New It is recommended to adopt a Mediterranean or similar diet to

lower risk of CVD. I

New It is recommended to restrict alcohol consumption to a maximum

of 100 g per week. I

New It is recommended to eat fish, preferably fatty, at least once a

week and restrict (processed) meat. I

New Patients with mental disorders need intensified attention and sup-

port to improve adherence to lifestyle changes and drug treatment. I

New Smoking cessation is recommended regardless of weight gain, as

weight gain does not lessen the ASCVD benefits of cessation. I

New In patients with established ASCVD, lipid-lowering treatment with an ultimate LDL-C goal of <1.4 mmol/L (55 mg/dL) and a >_50%

reduction of LDL-C vs. baseline is recommended. I

New For secondary prevention patients not achieving their goals on a maximum tolerated dose of a statin and ezetimibe, combination

therapy including a PCSK9 inhibitor is recommended. I

New In patients with type 2 DM at very high risk (e.g. with established

ASCVD and/or severe TOD), intensive lipid-lowering therapy, ultimately aiming at >_50% LDL-C reduction and an LDL-C of <1.4 mmol/L (<55 mg/dL) is recommended. I

New In patients with type 2 DM >40 years of age at high risk, lipid-lowering treatment with an ultimate LDL-C goal of >_50% LDL-C

reduction and an LDL-C of <1.8 mmol/L (70 mg/dL) is recommended. I

New It is recommended that the first objective of treatment is to lower BP to <140/90 mmHg in all patients, and that subsequent BP tar-

gets are tailored to age and specific comorbidities. I

New In treated patients aged 1869 years, it is recommended that SBP should ultimately be lowered to a target range of 120130

mmHg in most patients. I

New In treated patients aged >_70 years, it is recommended that SBP

should generally be targeted to <140 and down to 130 mmHg if tolerated. I

New In all treated patients, DBP is recommended to be lowered to

<80 mmHg. I

New In persons with type 2 DM and ASCVD, the use of a GLP-1RA or SGLT2 inhibitor with proven outcome benefits is recommended

to reduce CV and/or cardiorenal outcomes. I

New In patients with type 2 DM and CKD, the use of an SGLT2 inhibitor is recommended to improve CVD and/or cardiorenal

outcomes. I

New In patients with type 2 DM and HFrEF, use of an SGLT2 inhibitor

with proven outcome benefits is recommended to lessen HF hospitalizations and CV death. I

New Participation in a medically supervised, structured, comprehen-

sive, multidisciplinary EBCR and prevention programme for patients after ASCVD events and/or revascularization, and for patients with HF (mainly HFrEF), is recommended to improve patient outcomes. I

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