Research in preventive cardiology: Quo vadis?

Abstract

In the current position statement of the European Association of Preventive Cardiology of the European Society of Cardiology, 1 Massimo Piepoli et al. update the 2016 practice guidelines on primary prevention. 2 Recently, the American Heart Association and American College of Cardiology have also revised their primary prevention guidelines, 3,4 which emphasizes increasing importance and awareness of the topic of preventive cardiology, worldwide. However, despite the ubiquitous expert opinion of the key cardio-protective effects of a healthy lifestyle characterized by healthy nutrition (e.g. polyunsaturated fatty acids, vegetables, legumes, low content of salt and saturated fatty acids), non-smoking, maintaining a normal body weight (body mass index between 20 and 25 kg/m 2), low alcohol consumption and daily physical activity (30 min of moderate physical activity), 1,4-6 clinical research remains rather scarce, particularly with respect to randomized controlled intervention trials. So far, most data supporting the beneficial effects of a healthy lifestyle on cardiovascular disease have been retrieved from epidemiological cohort studies, 7-13 whereas numbers of large randomized controlled trials in preventive medicine confirming epidemiological hypotheses are low and significantly less compared to pharmacological intervention trials. Most of the intervention studies on the effects of lifestyle intervention are proof of concept studies involving less than 500 patients. Larger intervention trials enrolling more than 1000 individuals or patients, numbers comparable to pharmacological studies in cardiology, are very limited and confined to three trials overallthe Diabetes Prevention Program in Prediabetes (Diabetes Prevention Program, n ¼ 3234 overweight, prediabetic individuals randomized to metformin, lifestyle or usual care, follow-up 2.8 years) 14 ; the Look AHEAD (Action for Health in Diabetes) trial in type 2 diabetes (n ¼ 5145 overweight type 2 diabetes patients, randomized to lifestyle or usual care, 10-year followup) 15 ; and the HF ACTION (Heart Failure and A Controlled Trial Investigating Outcomes of exercise traiNing trial) (n ¼ 2331, exercise training versus usual care, three-year follow-up) 16 in patients with heart

New Approaches in Heart Research: Prevention Instead of Cardiomyoplasty?

“…The cardiological societies have long agreed on the cardioprotective effect of a healthy lifestyle. Essential components are a healthy diet, non-smoking, normal body weight, and physical activity [81]. Corresponding recommendations are now part of the ESC guidelines for treating coronary heart disease [82].…”

“…Corresponding recommendations are now part of the ESC guidelines for treating coronary heart disease [82]. However, a large part of the data comes from epidemiological studies, while there are few randomized and controlled prospective studies compared to pharmacological intervention studies [81]. The European Association of Preventive Cardiology has shown the ESC in a current position paper the gaps in cardiological prevention research and defined research goals for the coming years [83].…”

“…The European Association of Preventive Cardiology has shown the ESC in a current position paper the gaps in cardiological prevention research and defined research goals for the coming years [83]. A translational concept is proposed to understand lifestyle interventions from the pathophysiological mechanisms in the animal model to the clinical manifestation of the respective disease [81].…”

Optimizing therapy for cardiovascular diseases: proven organ-protective and preventive effects of pitavastatin and lercanidipine: A review

“…В профилактике ССЗ надежды возлагают на «персонализированную профилактику», которая позволит снизить распространенность ССЗ и вероятных серьезных осложнений [7]. Это относится и к выбору лекарственных средств, назначаемых конкретному пациенту.…”