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Cardiovascular prevention represents a cornerstone of modern strategies to reduce the burden of cardiovascular disease. It is of key importance to prevent cardiovascular diseases and associated events, not only to reduce morbidity and mortality, but also to increase the years of wellness in the aging population and to make the growing socio-economic burden imposed by cardiovascular events more sustainable.The current approach to prevention is based on an integrated use of effective lifestyle measures and, whenever appropriate, of antihypertensive and antidiabetic drugs, lipid-lowering agents and antiplatelet drugs.Given that population characteristics, in terms of ethnicity, demography and lifestyle habits, and healthcare system organizations differ among countries, international guidelines are not always applicable to specific countries and, often, are difficult to translate into daily clinical practice.In order to afford the specific features of Italy, 10 Scientific Societies and Research Institutions, mostly involved in preventive strategies, contributed to the present Italian consensus document, which includes brief, practical recommendations to support the preventive actions within the physician community and the general practice setting.

Competitive sports eligibility, mandatory for the Italian law in all age classes, from young to master athletes, involves millions of subjects, who are at risk during their sport career both for prescription and illicit drugs (or banned substances included in the World Anti-Doping Agency list, annually updated). These drugs may interfere with adrenergic hyperactivation related to athletic activity and can bring to unfavorable cardiovascular effects, such as arrhythmias, coronary artery disease, myocarditis, pericarditis, heart failure, ion channel disease. Moreover, numerous compounds may reduce athletic performance. Cardiovascular side effects are more frequently reported when drug co-administration is performed, which occurs frequently. Drug co-administration may have a higher risk when a common metabolic pathway is used (i.e. P450 hepatic cytochrome), and inhibition or induction effects modify plasma drug levels. One of the most important problems remains for combination of drugs that might be torsadogenic. Therefore, it is mandatory to be aware of pharmacokinetic properties, mechanisms of action, side effects and interactions between drugs and competitive sports activities; moreover, possible clinical, instrumental (i.e. ECG) or laboratory markers should be pointed out in order to recognize a possible toxic effect and subsequently interrupt or modify drug administration and/or assumption.