Primordial Prevention of Atherosclerotic Cardiovascular Disease

Abstract

The primordial prevention of atherosclerotic cardiovascular disease (ASCVD) involves the prevention of the onset of its risk factors. This review explores the associations between early modifiable risk factors and the development of ASCVD in adulthood, as well as evidence-based interventions to prevent them. Review Methods: A review was conducted on the basis of an indepth literature search including longitudinal observational data, systematic reviews and meta-analyses published in 2012 or later, clinical trials, and additional manual searches of recent literature based on reference lists of other reviews and relevant guidelines. Summary: ASCVD is a disease that begins in childhood; hence, primordial prevention is an important target for improving cardiovascular morbidity and mortality later in life. Data from large-scale population studies have consistently identified the following modifiable risk factors for the development of AS-CVD: smoking, overweight and obesity, high cholesterol, high blood pressure, hyperglycemia, poor diet, and physical inactivity. These risk factors originate during the prenatal, childhood, and adolescent stages of life. Various successful interventions to prevent the onset of each risk factor have been evaluated at the individual, community, and population levels. Implementation of a heart-healthy dietary pattern and regular exercise early in life are large components of many successful interventions.

Trends in cardiovascular disease among Inuit in Greenland from 1994 to 2021

“…It is advisable to focus on primary prevention, involving the prevention of the development of modifiable risk factors. Tobacco smoking, overweight/obesity, dyslipidemia, hypertension, hyperglycemia, poor diet, and physical inactivity during childhood are all associated with early onset of atherosclerosis [ 51 ]. The prevalence of obesity among preschool children was 21,7 % in 2003 [ 52 ], and daily smoking is more common than uncommon in Greenland [ 22 ].…”

Significance of lipids, lipoproteins, and apolipoproteins during the first 14–16 months of life

“… 6 This emphasizes the need to target potential risk factors as early as possible and prevent risk factors from occurring. 6 , 7 Therefore, childhood has been described as a ‘window of opportunity’ for preventing ASCVD. 8 A major reason to measure concentrations of lipids, lipoproteins, and apolipoproteins at birth and in early childhood is to identify familial hypercholesterolaemia (FH) which, if found, is actionable in childhood.…”

Nutraceuticals in the Prevention and Therapeutic Treatment of Cardiovascular and Cerebrovascular Disease

“…Despite extensive efforts, many middle-aged and older adults do not meet the minimal recommendations for physical activity/exercise or consume a healthy diet 8. Positive lifestyle behaviors are recognized as effective strategies to combat the detrimental effects of aging on the cardio- and cerebrovascular systems, but their implementation has often been hindered by poor adherence 8–10. As a result, there is growing interest in identifying alternative nonpharmacological strategies that provide similar health benefits as first-line behavioral changes for lowering CVD risk with improved adherence.…”

“…8 Positive lifestyle behaviors are recognized as effective strategies to combat the detrimental effects of aging on the cardio-and cerebrovascular systems, but their implementation has often been hindered by poor adherence. [8][9][10] As a result, there is growing interest in identifying alternative nonpharmacological strategies that provide similar health benefits as first-line behavioral changes for lowering CVD risk with improved adherence. Over the past decade the use of nutraceuticals has provided promising, yet limited evidence, that naturally occurring compounds and ingredients may have beneficial effects on cardiovascular health in humans.…”