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New sections Section 3 3.2.2 Sex and gender and their impact on health

3.2.3 Atherosclerotic cardiovascular disease risk classification

3.2.3.1 A stepwise approach to risk factor treatment and treatment intensification 3.2.3.2 Risk estimation in apparently healthy people

3.2.3.3 Translating atherosclerotic cardiovascular disease risk to treatment thresholds

3.2.3.4 Risk estimation and risk factor treatment in apparently healthy people 5069 years of age 3.2.3.5 Risk estimation and risk factor treatment estimation in apparently healthy people >_70 years of age

3.2.3.6 Risk estimation and risk factor treatment in apparently healthy people <50 years of age

3.2.3.7 Risk estimation and risk factor treatment in patients with established atherosclerotic cardiovascular disease 3.2.4 Communication of cardiovascular disease risk

3.3.1 Psychosocial factors

3.3.4 Frailty 3.3.8 Environmental exposure

3.4 Clinical conditions

3.4.2 Atrial fibrillation 3.4.3 Heart failure

3.4.5 Chronic obstructive pulmonary disease

3.4.6 Inflammatory conditions 3.4.7 Infections (human immunodeficiency virus, influenza, periodontitis)

3.4.8 Migraine

3.4.9 Sleep disorders and obstructive sleep apnoea 3.4.10 Mental disorders

3.4.11 Non-alcoholic fatty liver disease

3.4.12 Sex-specific conditions

Section 4 • 4.10 Anti-inflammatory treatment

New /revised concepts Section 3 • SCORE2 and SCORE2-OP risk charts for fatal and non-fatal (myocardial infarction, stroke) ASCVD • Estimating 10-year total CVD risk in apparently healthy people 5069 years of age • Estimating lifetime risk in apparently healthy people <50 years of age • Estimating 10-year total CVD risk in apparently healthy people >_70 years of age • Cut-offs of 10-year CVD risk, based on SCORE2/SCORE2-OP, to define lowmoderate risk, high risk, and very high risk for

apparently healthy people in different age groups (<50, 5069, and >_70 years) • Estimating 10-year CVD risk in patients with established CVD and/or DM • Lifetime benefit of stopping smoking, reducing LDL-C, or lowering SBP (sections 3 and 4) • A stepwise approach to attaining ultimate treatment goals (sections 3 and 4) • Communication of CVD risk and benefit of treatment to patients in an understandable way • Stepwise approach to risk factor treatment and treatment intensification Section 4 • Explicitly addressing cost-effectiveness (on a loco-regional or national level) before implementing some recommendations • Non-fasting lipid measurement (section 4.6.1.1) • A stepwise approach to attaining treatment goals (sections 3 and 4) • Anti-inflammatory treatment for very-high-risk patients

Section 5 • Taking into consideration population level interventions to mitigate the effects of pollution on CVD health

Section 6 • Risk management of disease-specific CVD. This section addresses CVD prevention when certain underlying diseases are present and aims to provide guidance on how to prevent the worsening of existing, or the development of further, comorbidities that could increase the overall risk of CVD • Subsections include: 6.1 Coronary artery disease; 6.2 Heart failure; 6.3 Cerebrovascular disease; 6.4 Lower extremity artery disease; 6.5 Chronic kidney disease; 6.6 Atrial fibrillation; 6.7 Multimorbidity

ASCVD = atherosclerotic cardiovascular disease; CVD = cardiovascular disease; DM =diabetes mellitus; LDL-C = low-density lipoprotein cholesterol; SBP = systolic bloodpressure; SCORE2 = Systematic Coronary Risk Estimation 2; SCORE2-OP = Systematic Coronary Risk Estimation 2-Older Persons. ESC 2021 Downloaded from academic.oup.com/eurheartj/article/42/34/3227/6358713 by guest on 07 October 2026