CHAPTER 12 Prevention of Cardiovascular Disease
The global increase in cardiovascular disease (CVD) during the 20th century is partially explained by an increasing proportion of older adults in the population, but also by changes in work conditions, transport, diet, and social networks, all of which have a direct impact on risk factors for CVD. Although the mortality rate is falling markedly in some European countries, it is increasing in others and CVD is expected to remain the leading cause of premature death in Europe in the coming decades.CVD is strongly related to individual lifestyle characteristics and associated risk factors. In seeking to prevent CVD in the population, the objectives are to reduce mortality and morbidity and improve the chances of a longer life expectancy with preserved quality of life. Risk behaviour can be modified successfully through lifestyle management. Single risk factors such as hyperlipidaemia and hypertension can be controlled by adding pharmacotherapy. Thus, there are effective tools both for the detection and for the modification of CVD risk.
In this chapter, prevention strategies and priorities are presented in agreement with the recent guidelines of the Fourth Joint European Societies Task Force on CVD prevention in clinical practice. The detection and modification of risk factors is described in the sections on smoking, physical activity, blood pressure, nutrition, obesity, and lipids. The chapter includes specific methods for lifestyle counselling; drug therapy has been recommended, whenever deemed appropriate. Finally, new evidence on the importance of psychosocial risk factors and the influence of gender will also be discussed.
Chapter 28)
