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Recommendations for cardiovascular disease risk assessment in specific clinical conditions In all CKD patients, with or without DM, appropriate screening for ASCVD and kidney disease progression, including monitoring changes in albuminuria is recommended. I C It is recommended to monitor cardiac dysfunction using imaging techniques and circulating biomarkers before, periodically during, and after cancer treatment. I B Screening for CV risk factors and optimization of the CV risk profile is recommended in patients on treatment for cancer. I C It is recommended that all COPD patients be investigated for ASCVD and ASCVD risk factors. I C In patients with CVD, obesity, and hypertension, regular screening for non-restorative sleep is indicated (e.g. by the question: ‘how often have you been bothered by trouble falling or staying asleep, or sleeping too much?’). I C If there are significant sleep problems, which are not responding within 4 weeks to sleep hygiene, referral to a specialist is recommended. I C It is recommended that mental disorders with either significant functional impairment or decreased use of healthcare systems be considered as influencing total CVD risk. I C It is recommended for adults of all ages to strive for at least 150300 min a week of moderate-intensity or 75150 min a week of vigorous-intensity aerobic PA, or an equivalent combination thereof, to reduce all-cause mortality, CV mortality, and morbidity. I A It is recommended that adults who cannot perform 150 min of moderate-intensity PA a week should stay as active as their abilities and health condition allow. I B It is recommended to reduce sedentary time to engage in at least light activity throughout the day to reduce all-cause and CV mortality and morbidity. I B Performing resistance exercise, in addition to aerobic activity, is recommended on 2 or more days per week to reduce all-cause mortality. I B Recommendations for nutrition and alcohol A healthy diet is recommended as a cornerstone of CVD prevention in all individuals. I A It is recommended to adopt a Mediterranean or similar diet to lower risk of CVD. I A It is recommended to replace saturated with unsaturated fats to lower the risk of CVD. I A It is recommended to reduce salt intake to lower BP and risk of CVD. I A It is recommended to choose a more plant-based food pattern, rich in fibre, that includes whole grains, fruits, vegetables, pulses, and nuts. I B It is recommended to restrict alcohol consumption to a maximum of 100 g per week. I B It is recommended to eat fish, preferably fatty, at least once a week and restrict (processed) meat. I B It is recommended to restrict free sugar consumption, in particular sugar-sweetened beverages, to a maximum of 10% of energy intake. I B Recommendations for body weight It is recommended that overweight and obese people aim for a reduction in weight to reduce BP, dyslipidaemia, and risk of type 2 DM, and thus improve their CVD risk profile. I A While a range of diets are effective for weight loss, it is recommended that a healthy diet in regard to CVD risk is maintained over time. I A Recommendations for mental healthcare and psychosocial interventions at the individual level Patients with mental disorders need intensified attention and support to improve adherence to lifestyle changes and drug treatment. I C In ASCVD patients with mental disorders, evidence-based mental healthcare and interdisciplinary cooperation are recommended. I B In patients with HF and major depression, SSRIs, SNRIs, and tricyclic antidepressants are not recommended. III B Recommendations for smoking intervention strategies All smoking of tobacco should be stopped, as tobacco use is strongly and independently causal of ASCVD. I A Smoking cessation is recommended regardless of weight gain, as weight gain does not lessen the ASCVD benefits of cessation. I B Recommendations on low-density lipoprotein cholesterol goals A stepwise treatment-intensification approach is recommended for apparently healthy people at high or very high CVD risk, as well as patients with established ASCVD and/or DM with consideration of CVD risk, treatment benefit, risk modifiers, comorbidities, and patient preferences. I C

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