New guidelines released for the prevention of cardiovascular disease

Cardiovascular disease (CVD) is the leading cause of death worldwide and is considered a global health problem. Extensive research has identified contributing risk factors to CVD such as smoking, high blood pressure, cholesterol abnormalities, elevated glucose and advancing age. It is important that all countries have appropriate strategies to address these risk factors and reduce the burden of CVD on society. A task force of researchers of the World Health and Stroke form (WHF) has therefore provided a detailed report explaining principles involved in CVD prevention and offered specific recommendations to help countries establish national clinical guidelines. Hopefully with such knowledge, policy makers worldwide can benefit, so they can better address the growing international problem of CVD.

Cardiovascular disease (CVD) is the leading cause of death worldwide and creates major health burdens in all countries. The prevalence and burden of CVD is set to increase given the aging of the population and the decline in other diseases such as infections and nutritional disorders. Particular attention must be given to the prevention of CVD through targeting at risk individuals and creating population strategies to address identified risk factors and lifestyles. The World Heart and Stroke Forum (WHSF) Guidelines Task Force of the World Heart Federation (WHF) has therefore provided recommendations to act as a template for the development of national clinical guidelines. Hopefully, the publishing of such data will lead to all countries developing strategic methods for CVD prevention and in turn reduce the worldwide suffering and mortality associated with the disease. The report highlights established major and minor risk factors for CVD and importance of overall cardiovascular disease risk in the management of patients. In particular, tobacco smoking, hypertension (high blood pressure), elevated serum LDL cholesterol (the bad cholesterol that causes plaques in blood vessels), diabetes, low HDL cholesterol (good cholesterol) and advancing age have been identified as key risk factors from previous research. The greater number of risk factors present in a patient, the more likely they are to have an adverse cardiovascular event such as stroke or heart attack. Other secondary risk factors such as obesity, physical inactivity, poor diet, family history and genetic and racial factors are also involved in CVD risk. All countries need policies to address these risk factors. Often this may focus on treatment of patients already at risk but widespread health promotion is also necessary to reduce such risk factors across the entire population. Health campaigns to reduce tobacco use, improve diet and encourage weight reduction and exercise are very important in preventing CVD.Researchers suggested reliably finding patients at highest risk of CVD can help target treatment and reduce overall health costs. If you have a combination of the above risk factors, you will benefit most from treatments such as lifestyle changes and medications to address blood pressure, cholesterol and diabetes. If the country has established proper guidelines, they should be able to identify appropriate patients for treatment and reduce the risk of further CVD events. Both treatment of individual patients and prevention strategies must be adequate and in an appropriate balance. All countries should have the same general aims but the methods they use will differ significantly. The report from the WHSF therefore aimed to highlight important principles to be considered in forming national guidelines. In other words, it provides the necessary information to help health professionals and policy makers across the nation, decide how they will address the problem of CVD. Health professionals will play a big role and it is likely that patients may be questioned about risk factors regularly and may receive treatments even if they do not have established CVD. Key recommendations from this report focused on collaboration between governments, national societies and foundations in the formation of clinical guidelines and prevention of CVD risk factors. They also suggested methods countries can use to monitor the incidence (how common a disease is) and how well treatments are working in patients. Previous studies have suggested the importance of health prevention techniques, which was not extensively addressed by this report. Hopefully with the information this report provides on board, governments and health agencies will be better able to address the huge and growing health problem of CVD which will benefit individual patients and the overall population.(Source: Smith et al. ‘Principles for National and Regional Guidelines onCardiovascular Disease Prevention- A Scientific Statement from the World Heart and Stroke Forum,’ American Heart Association 2004. DOI: 10.1161/01.CIR.0000133427.35111.67.)