Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Aug;20(7-8):320-5.
doi: 10.1007/s12471-012-0268-8.

Cardiovascular risk management of hypertension and hypercholesterolaemia in the Netherlands: from unifactorial to multifactorial approach

I van Dis  1 , J M Geleijnse, W M M Verschuren, D Kromhout
Affiliations

Cardiovascular risk management of hypertension and hypercholesterolaemia in the Netherlands: from unifactorial to multifactorial approach

I van Dis et al. Neth Heart J. 2012 Aug.

Abstract

About 30 years ago, the first Dutch unifactorial guidelines on hypertension and hypercholesterolaemia were developed. These guidelines have been revised several times, often after publication of landmark studies on new generations of drugs. In 1978, cut-off points for pharmacological treatment of hypertension were based on diastolic blood pressure values ≥115 mmHg, and in 2000 they were lowered to >100 mmHg. From 1997 onwards, cut-off points for systolic blood pressure values >180 mmHg were introduced, which became leading. In 1987, cut-offs for hypercholesterolaemia of ≥8 mmol/l were set and from 2006 pharmacological treatment was based on a total/HDL cholesterol ratio >8. Around 2000, treatment decisions for hypertension and/or hypercholesterolaemia were no longer based on high levels of individual risk factors, but on a multifactorial approach based on total risk of cardiovascular diseases (CVD), determined by a risk function. In the 2006 multidisciplinary guideline on cardiovascular risk management, the Framingham risk tables were replaced by European SCORE risk charts. A cut-off point of 10% CVD mortality was set in the Netherlands. In 2011, this cut-off point changed to 20% fatal plus nonfatal CVD risk. Nowadays, 'the lower the risk factors, the lower the absolute risk' is the leading paradigm in CVD prevention.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Overview of guidelines on hypertension, hypercholesterolaemia, and cardiovascular risk management by year, and treatment levels. CBO Former Dutch Institute for Healthcare Improvement (Utrecht); NHG Dutch College of General Practitioners (Utrecht). CHD coronary heart disease; CVD cardiovascular diseases; DBP diastolic blood pressure; SBP systolic blood pressure, HDL cholesterol, high-density lipoprotein cholesterol
Fig. 2
Fig. 2
Impression of risk charts in the 1998 Guideline on Cholesterol, the 2000 Guideline on High blood pressure and the 2006 Guideline on Cardiovascular Risk Management
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Interim advice on hypertension. Health Council, The Hague, 1978/18.
    1. Advice on hypertension. Health Council, The Hague, 1983/2.
    1. Cholesterol. Health Council, The Hague, 1990/1.
    1. Consensus diagnostics and treatment of hypertension. Hart Bulletin 1990;21:142–210.
    1. Cholesterol consensus. Hart Bulletin supplement 1987;1:3–64.

LinkOut - more resources