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A Comparison of American and European Guidelines for Primary Prevention of Cardiovascular Disease

By Dr. Suzanne Steinbaum | Posted Jun 28, 2022


Cardiovascular disease is the leading cause of death worldwide. In an effort to reduce the burden of this disease, both the American Heart Association (AHA) and the European Society of Cardiology (ESC) have released guidelines for the primary prevention of cardiovascular disease in women. Although there are some similarities between the two sets of guidelines, there are also some critical differences. Let’s take a closer look at both.

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American Heart Association

The AHA recommends screening women for cardiovascular disease risk factors starting at age 20. Risk factors that should be considered include high blood pressure, high cholesterol, diabetes, smoking, and family history.

European Society of Cardiology

The ESC recommends screening women for cardiovascular disease risk factors starting at age 40. However, the ESC also recommends that women with certain risk factors (e.g., diabetes, hypertension, smoking, or obesity) be screened earlier than age 40.

AHA and ESC both support cardiovascular disease prevention via lifestyle changes.

Both guidelines recommend lifestyle changes as the primary means of preventing cardiovascular disease. These lifestyle changes include eating a healthy diet, exercising regularly, maintaining a healthy weight, and avoiding tobacco use. The AHA also recommends that women with established atherosclerosis take aspirin daily as an additional measure to prevent cardiovascular disease. The ESC does not make a specific recommendation regarding aspirin use. ESC does, however, note that aspirin may be considered in certain high-risk populations.

Although there are some similarities between the AHA and ESC guidelines for primary prevention of cardiovascular disease in women, there are also some important differences. Ultimately, both guidelines try to prevent heart disease and stroke.

Cardiovascular disease prevention needs to be a conversation between you and your primary care provider.

Whether your doctor follows the AHA or ESC guidelines, prevention begins with an honest conversation with your healthcare provider. Remember, lifestyle changes like eating a healthy diet and exercising regularly are still the best way to prevent cardiovascular disease!