Cardiovascular diseases

High Risk Approach

The purpose of the high-risk approach is to prevent morbidity, early mortality and improve general of quality of life due to cardiovascular disease (CVD) in individuals with an elevated total CVD risk. Total CVD risk is defined as the probability of a cardiovascular event (e.g. stroke or myocardial infarction) occurring within a given time period. It is determined by the risk factor profile, which is dependent on combined risk factors, as well as sex and age. An individual with several mildly elevated levels may have a higher total CVD risk than of an individual with one elevated risk factor.  The intensity of the prevention strategy should be guided by level of total risk. Lifestyle interventions addressing diet, exercise, smoking habits and, when needed, drug treatment will reduce the risk of cardiovascular disease.

Atherosclerosis, the process of plaque building up in the arteries, is the main pathological process contributing to cardiovascular diseases. The process begins early in life, but the rate in which it progresses and potentially leads to CVD is influenced by several factors including:

• Tobacco use
• Unhealthy diet and physical inactivity leading to obesity
• Elevated blood pressure (hypertension)
• Abnormal blood lipids (dyslipidemia)
• Elevated blood glucose (diabetes)

Management of CVD

Population-based and high-risk approaches are complementary and necessary in reducing cardiovascular disease. Additionally, management of CVD, particularly through management of hypertension, is an important component in a comprehensive approach addressing this problem. Hypertension is a highly prevalent risk factor for heart disease in the Americas and globally. Risk for CVD increases as blood pressure increases, and scientific evidence has shown that even a small reduction in blood pressure reduces the risk for a cardiovascular event. Therefore, individuals of all risk levels are advised to take part in healthy lifestyle modifications that result in lower blood pressure. Drug treatment may be necessary in managing cardiovascular disease; however lifestyle changes provide significant cardiovascular benefits. There are several lifestyle modifications that will help all individuals in the prevention and management of cardiovascular diseases, including hypertension:

• weight loss;
• cessation of tobacco use;
• increasing physical activity;
• moderation of alcohol intake;
• increasing fresh fruit and vegetable intake;
• reducing saturated fat intake;
• reducing sodium intake.