Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Possible Approaches to Primary Prevention of Cardiovascular Diseases

https://doi.org/10.20996/1819-6446-2020-10-12

Full Text:

Abstract

In recent years there is a positive trend in the development of preventive medicine, in particular, primary prevention of diseases. However, in most cases, patients seek help from a doctor after the manifestation of the disease, and therefore, early identification of risk factors (RF) remains relevant. Conduction of a large number of studies that are aimed at studying modifiable RF associated with the development of cardiovascular diseases (CVD), allowed the experts of the American Heart Association to develop recommendations “Life's Simple 7”, which makes it possible to structure methods of primary prevention of CVD and minimize the risk of their development. In 2019, experts from the American College of Cardiology presented a simplified version of these recommendations, to improve approaches to primary prevention and their effectiveness not only for doctors but also for patients. Thus, by involving the patient in the decision-making process about follow-up treatment, doctors can achieve a high level of compliance, which is essential for improving the prognosis. The “ABCDE” recommendations, in name of which are reflected the first letters of the leading CVD RF, include such paragraphs as RF assessment, the use of antiaggregating therapy, correction of blood pressure, cholesterol levels, smoking elimination, correction of high glucose levels and diabetes treatment, weight loss, assessment of social and economic factors affecting the morbidity in a particular patient. Despite the undoubted benefit of the “ABCDE” recommendations, some problems of primary prevention currently cannot be solved: the inability to accurately assess social and economic RF; the imperfection of the used CVD risk scales. The updated version of the recommendations allows not only to assess the existing RF of the patient, but also to effectively correct them. In addition, the patient himself can read the recommendations, which improves understanding of the primary prevention importance.

About the Authors

V. N. Larina
Pirogov Russian National Research Medical University
Russian Federation

Vera N. Larina – MD, PhD, Professor, Head of Chair of Outpatient Therapy

Ostrovitianova ul. 1, Moscow, 117997



D. S. Mkrtychev
Pirogov Russian National Research Medical University
Russian Federation

David S. Mkrtychev – Student

Ostrovitianova ul. 1, Moscow, 117997



V. A. Kuznetsova
Pirogov Russian National Research Medical University
Russian Federation

Veronika A. Kuznetsova – Student

Ostrovitianova ul. 1, Moscow, 117997



A. A. Tyazhelnikov
Moscow Consultative and Diagnostic Polyclinic №121
Russian Federation

Andrey A. Tyazhelnikov – MD, Chief Medical Officer

Uzhnobutovskaya ul. 87, Moscow, 117042



References

1. Kontsevaya A.V., Drapkina O.M. Economics of the prevention of chronic non-communicable diseases. Russian Journal of Preventive Medicine and Public Health. Profilakticheskaya Meditsina. 2018;21(2):4- 10 (In Russ.) DOI:10.17116/profmed20182124-10.

2. Katharina L., von Schacky C., McKenzie A.L., et al. Lifestyle factors and high-risk atherosclerosis: Pathways and mechanisms beyond traditional risk factors. Eur J Prev Cardiol. 2020 Mar;27(4):394-406. DOI:10.1177/2047487319869400.

3. Drapkina O.M., Drozdova L.Yu., Kalinina A.M., et al. Organization of preventive medical examination and medical examination of certain groups of the adult population. Guidelines for the practical implementation of the order of the Ministry of Health of Russia dated March 13, 2019 N 124н “On approval of the procedure for conducting preventive medical examination and medical examination of certain groups of the adult population”. Moscow: NMITsTPM; 2019 (In Russ.)

4. Kalinina A.M., Kushunina D.V., Gornyj B.E. The tasks of improving the quality of medical examination of the adult population as an important tool to prevent cardiovascular diseases in primary health care. Preventive Medicine. 2018;21(5):227 (In Russ.) DOI:10.17116/profmed20182105122.

5. Kalinina A.M., Kushunina D.V., Gornyi B.E., et al. The potential of cardiovascular diseases’ prevention according to the results of dispensary examinations of the adult population. Cardiovascular Therapy and Prevention. 2019;18(4):69-76 (In Russ.) DOI:10.15829/1728-8800-2019-4-69-76.

6. Piepoli M.F., Hoes A.W., Agewall S., et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315-81. DOI:10.1093/eurheartj/ehw106.

7. Urazalina S.J., Semenova A.E., Sergienko I.V., et al. Subclinical atherosclerosis as cardiovascular events risk factor. Cardiovascular Therapy and Prevention. 2012;11(3):82-6 (In Russ.)

8. Mach F., Baigent C., Catapano A.L., et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019;290:140-205. DOI:10.1016/j.atherosclerosis.2019.08.014.

9. Berger J.S., Jordan C.O., Lloyd-Jones D., Blumenthal R.S. Screening for cardiovascular risk in asymptomatic patients J Am Coll Cardiol. 2010;55(12):1169-77. DOI:10.1016/j.jacc.2009.09.066.

10. Kalinina A.M. Multifactor primary prevention of ischemic heart disease in middle-aged men and its efficacy (10-year follow-up). Rational Pharmacotherapy in Cardiology. 2014;10(1):6-17 (In Russ.) DOI:10.20996/1819-6446-2014-10-1-6-17.

11. Arnett D.K., Blumenthal R.S., Albert M.A., et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596-e646. DOI:10.1161/CIR.0000000000000678.

12. Passport of the priority project “Formation of a healthy lifestyle” [cited by Jan 12, 2019]. Available from: http://base.garant.ru/71748614/ (In Russ.)

13. Shalnova S.A., Balanova Yu.A., Deev A.D., et al. Integral assessment of adherence to a healthy lifestyle as a way to monitor the effectiveness of preventive measures. Preventative Medicine. 2018;21(4):65- 72. (In Russ.) DOI:10.17116/profmed201821465.

14. Shalnova S.A., Kapustina A.V., Deev A.D., Balanova YA. Factors Associated with Cause-Specific Death in Russia. Data from Longitudinal Prospective Study 1977-2001. Rational Pharmacotherapy in Cardiology. 2019;15(1):4-16 (In Russ.) DOI:10.20996/1819-6446-2019-15-1-4-16.

15. Dolgalev I.V., Brazovskaya N.G., Ivanova A.Y., et al. Influence of arterial hypertension, smoking, and their combination on mortality (according to the results of a 27-year cohort prospective study of the unorganized population of Tomsk). Russian Journal of Cardiology. 2019;(1):32-7 (In Russ.) DOI:10.15829/1560-4071-2019-1-32-37.

16. Arnett D.K., Blumenthal R.S., Albert M.A., et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):e177-e232. DOI:10.1016/j.jacc.2019.03.010.

17. Boytsov S.A., Pogosova N.V. Cardiovascular Prevention 2017. National Recommendations Russ J Cardiol. 2018;23(6):7-122 (In Russ.) DOI:10.15829/1560-4071-2018-6-7-122.

18. Piepoli M., Hoes A., Agewall S., et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37:235-81. DOI:10.1093/eurheartj/ehw106.

19. Damen J.A., Pajouheshnia R., Heus P., et al. Performance of the Framingham risk models and pooled cohort equations for predicting 10-year risk of cardiovascular disease: a systematic review and meta-analysis. BMC Medicine. 2019;17(1):109. DOI:10.1186/s12916-019-1340-7.

20. Lewis J., Bethishou L., Tsu L.V. Aspirin Use for Primary Prevention of Cardiovascular Disease in Older Patients: A Review of Clinical Guidelines and Updated Evidence. Sr Care Pharm. 2019;34(9):580-94. DOI:10.4140/TCP.n.2019.580.

21. De Berardis G., Sacco M., Strippoli G.F., et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials. BMJ. 2009;339:b4531. DOI:10.1136/bmj.b4531.

22. Mach F., Baigent C., Catapano A.L., et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-88. DOI:10.1093/eurheartj/ehz455.

23. Sabatine M.S., Giugliano R.P., Keech A.C., et al.; FOURIER Steering Committee and Investigators. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017;376(18):1713-22. DOI:10.1056/NEJMoa1615664.

24. Schwartz G.G., Steg P.G., Szarek M., et al.; ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and cardiovascular outcomes after acute coronary syndrome. N Engl J Med. 2018;379(22):2097-107. DOI:10.1056/NEJMoa1801174.

25. Research organizing committee of the ESSE-RF project. Epidemiology of cardiovascular diseases in different regions of Russia (ESSE-RF). The rationale for and design of the study J. Profilakticheskaya Meditsina. 2013;6:5-34 (In Russ.)

26. Wang T.W., Asman K., Gentzke A.S., et al. Tobacco product use among adults—United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67(44):1225-32. DOI:10.15585/mmwr.mm6744a2.

27. Filippov E.V., Yakushin S.S., Petrov V.S. Dyslipidemia and its relationship with chronic non-communicable diseases (according to the MERIDIAN-RO study). Clinician. 2016;10(3):32-40 (In Russ.)

28. Dolgalev I.V., Brazovskaya N.G., Ivanova A.Y., et al. Influence of arterial hypertension, smoking, and their combination on mortality (according to the results of a 27-year cohort prospective study of the unorganized population of Tomsk). Russian Journal of Cardiology. 2019;(1):32-7 (In Russ.) DOI:10.15829/1560-4071-2019-1-32-37

29. Bhatnagar A. Cardiovascular Perspective of the Promises and Perils of E-Cigarettes. Circ Res. 2016;118(12):1872-5. DOI:10.1161/CIRCRESAHA.116.308723.

30. Lippi G., Favaloro E.J., Meschi T., et al. E-cigarettes and cardiovascular risk: beyond science and mysticism. Semin Thromb Hemost. 2014;40:60-5. DOI:10.1055/s-0033-1363468.

31. Moheimani R.S., Bhetraratana M., Yin F., et al. Increased cardiac sympathetic activity and oxidative stress in habitual electronic cigarette users: implications for cardiovascular risk. JAMA Cardiol. 2017;2:278- 84. DOI:10.1001/jamacardio.2016.5303.

32. Gambaryan M.G. The whole truth of electronic cigarettes: the Russian reality. Part I. Electronic cigarettes a threat to people and Tobacco control policy in Russia. Urgency for legal regulation. Preventive Medicine. 2019;22(5):7-15 (In Russ.) DOI:10.17116/profmed2019220517.

33. Boytsov S.A. Prevalence of cardiovascular risk factors and cardiovascular prevention quality in primary healthcare in Russia and European countries: EURIKA Study results. Cardiovascular Therapy and Prevention. 2012;11(1):11-6 (In Russ.)

34. Erina A.M., Rotar O.P., Orlov A.V., et al. Prehypertension and cardiometabolic risk factors (data of the ESSE-RF study) Arterial Hypertension. 2017;23(3):243-52 (In Russ.) DOI:10.18705/1607-419X2017-23-3-243-252.

35. Krivoshapova K.E., Tsygankova D.P., Barbarash O.L. Physical inactivity as a risk factor for cardiovascular morbidity and mortality. Systemic Hypertension. 2018;15(3):14-20 (In Russ.) DOI:10.26442/2075-082X_2018.3.14-20.

36. Löllgen H., Böckenhoff A., Knapp G. Physical Activity and All-cause Mortality: An Updated Meta-analysis with Different Intensity Categories. International Journal of Sports Medicine. 2009;30(03):213-24. DOI:10.1055/s-0028-1128150.

37. Vyalova M.O., Shvarts Yu.G. Arterial hypertension and cardiovascular risk score in people in their middle and late adulthood during sports and physical training. Kardiologiya: Novosti, Mneniya, Obuchenie. 2019;7(2):36-44 (In Russ.) DOI:10.24411/2309-1908-2019-12004.

38. Goginava S.E., Rumba O.G. Combination of the loads of aerobic and anaerobic characters during the physical culture classes in higher education. Scientific-theoretical journal Uchenye zapiski universiteta imeni P.F. Lesgafta. 2013;7(101):38-43 (In Russ.) DOI:10.5930/issn.1994-4683.2013.07.101.p38-43.

39. Ametov A.S., Pashkova E.Yu., Sharafetdinov A.S., Zhigareva A.V. The role and place of sodium-glucose cotransporter-2 inhibitors in multifactorial management of type 2 diabetes mellitus. Endokrinologiya: Novosti, Mneniya, Obuchenie. 2019;8(1):8-16 (In Russ.) DOI:10.24411/2304-9529-2019-11001.

40. Meier J.J. GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology. 2012;8(12):728-42. DOI:10.1038/nrendo.2012.140.

41. Billioux A., Verlander K., Anthony S., Alley D. Standardized Screening for Health-Related Social Needs in Clinical Settings: The Accountable Health Communities Screening Tool. NAM Perspectives. Discussion Paper. Washington, DC: National Academy of Medicine; 2017. DOI:10.31478/201705b.


For citation:


Larina V.N., Mkrtychev D.S., Kuznetsova V.A., Tyazhelnikov A.A. Possible Approaches to Primary Prevention of Cardiovascular Diseases. Rational Pharmacotherapy in Cardiology. 2020;16(5):831-841. (In Russ.) https://doi.org/10.20996/1819-6446-2020-10-12

Views: 207


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)