Revised guidelines for cardiovascular risk management

摘要

With interest we read the study by van Duijn ef al regarding the revised Dutch guidelines for cardiovascular risk management.1 The authors conducted a practice-based intervention study to explore the feasibility and consequences of a re-evaluation programme for patients without target organ damage, who were treated for hypertension and/or hypercholesterolemia under the previous guidelines. After reading their conclusions some questions remained. First, the authors conclude that stopping medication in this group of patients can be assumed to be safe, as no important adverse effects such as heart failure or cardiovascular events took place during the 6-month follow-up. Considering the relatively small group of patients, short follow-up time, and lack of an appropriate control group, we doubt such a conclusion can be drawn based on these results. We feel that a more appropriate outcome regarding safety is the effect of