Guidelines of the Spanish Society of Cardiology for cardiovascular diseaseprevention and cardiac rehabilitation

The priorities for the prevention of cardiovascular diseases should be focu sed on patients with established disease and high risk subjects, with indiv idual global risk always being taken into account. The current evidence on the influence of the main risk factors are unanimou s (dyslipemia, tobacco, hypertension and diabetes mellitus), being somewhat less so in cases of sedentarism, obesity and the metabolic syndrome. The e vidence concerning other risk factors still remains controversial. Guidelines for the control of the different risk factors should be based on the evidence derived from both epidemiological or clinical trials. The rec ommendations published by several scientific societies should also be follo wed. There are, at present, important evidence on the efficacy of smoking cessat ion, the treatment of arterial hypertension and particularly on the success ful control of lipid levels with lipid-lowering drugs, especially with stat ins. There is also evidence on the need for rigorous control of diabetic pa tients not only in relation to the glucose levels but also to dyslipemia. The most efficient measures for a reduction in morbidity and mortality are cessation of smoking, appropriate hypertensive therapy, a comprehensive pro gram of cardiac rehabilitation and overall the successful control of lipid levels with statins.