Comentario del CEIPV a la actualización de las Guías Europeas de Prevención Vascular en la Práctica Clínica
e202009102
Palabras clave:
Prevención y control, Enfermedades vasculares, Guías de Práctica Clínicas, Dieta saludable, Hipertensión arterial, Diabetes, Control de lípidos, TabacoResumen
Presentamos la adaptación para España de la actualización de las Guías Europeas de Prevención Vascular. En esta actualización se hace mayor énfasis en el abordaje poblacional, especialmente en la promoción de la actividad física y de una dieta saludable mediante políticas alimentarias y de ocio y transporte activo en España. Para estimar el riesgo vascular, se destaca la importancia de recalibrar las tablas que se utilicen, adaptándolas a los cambios poblaciones en la prevalencia de los factores de riesgo y en la incidencia de enfermedades vasculares, con particular atención al papel de la enfermedad renal crónica. A nivel individual resulta clave el apoyo personalizado para el cambio de conducta, la adherencia a la medicación en los individuos de alto riesgo y pacientes con enfermedad vascular, la promoción de la actividad física y el abandono del hábito tabáquico. Además, se revisan los ensayos clínicos recientes con inhibidores de PCKS9, la necesidad de simplificar el tratamiento farmacológico de la hipertensión arterial para mejorar su control y la adherencia al tratamiento. En los pacientes con diabetes mellitus 2 y enfermedad vascular o riesgo vascular alto, cuando los cambios de estilo de vida y la metformina resultan insuficientes, deben priorizarse los fármacos con demostrado beneficio vascular. Por último, se incluyen pautas sobre enfermedad arterial periférica y otras enfermedades específicas, y se recomienda no prescribir antiagregantes en prevención primaria.
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Derechos de autor 2020 Pedro Armario, Carlos Brotons, Roberto Elosua, María Alonso de Leciñana, Almudena Castro, Albert Clarà, Olga Cortés, Ángel Díaz Rodriguez, María Herranz, Soledad Justo, Carlos Lahoz, Juan Pedro-Botet, Antonio Pérez Pérez, Rafael Santamaría, Ricard Tresserras, Susana Aznar Lain, Miguel Ángel Royo-Bordonada
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