1. While the major causes of atherosclerotic cardiovascular disease are known, clinical audits continue to show inadequate risk factor control, even in the highest risk subjects. 2. More effective risk estimation methods may help, and advances in this field are outlined. 3. There exist excellent Guidelines on cardiovascular disease prevention, but their very length and complexity may limit their use. Other factors inhibiting guideline implementation are explored. 4. While new medications continue to be developed, the real challenges to effective CVD prevention are societal and political. Both nationally and at European levels, cohesive, integrated strategies with defined responsibilities and accountability are needed, together with empowerment of people to understand the concept of risk and what they can do about it. 5. There are profound health inequalities between and within countries that need to be addressed.

中文翻译：

---

2023年心血管疾病预防方面最大的未满足需求。

1. 虽然动脉粥样硬化性心血管疾病的主要原因是已知的，但临床审计仍然表明风险因素控制不足，即使是在风险最高的受试者中也是如此。2. 更有效的风险评估方法可能会有所帮助，并概述了该领域的进展。3. 关于心血管疾病预防已有很好的指南，但其篇幅和复杂性可能会限制其使用。探讨了阻碍指南实施的其他因素。4. 虽然新药物不断被开发，但有效预防心血管疾病的真正挑战来自社会和政治。无论是在国家层面还是在欧洲层面，都需要制定具有明确责任和问责制的连贯、综合战略，同时赋予人们权力，让他们了解风险的概念以及他们可以采取哪些措施。5. 国家之间和国家内部存在严重的健康不平等问题需要解决。