EDITORIAL: No-Pharmacological Intervention: Pomegranate Juice for the Managementof Hypertension and the Improvement of Cardiovascular Health

Abstract

The concept of ideal cardiovascular (CV) health, with emphasis on the prevention of CV disease (CVD), was included by the American Heart Association (AHA) among its strategic goals for 2020 [1]. This concept was intended to focus mainly on the promotion of a healthy lifestyle and the adoption of a multifactorial intervention with nonpharmacological or pharmacological means, aiming at the prevention or the effective control of CVD risk factors [1]. Ideal CV health is defined as optimal levels of 3 CVD risk factors [blood pressure (BP), fasting plasma glucose and total cholesterol) and 4 behaviours [body mass index (BMI), smoking, physical activity and healthy diet] [1]. These 7 ideal CV metrics, called life's simple 7, are probably the best available markers of life-time CVD risk [2]. Recent studies have shown that the levels of ideal CV health in the United States to be very low at a community level [3-5] and to be associated with cardiac events [3], stroke [2] and total mortality [6]. A large study was conducted in 5,785 young adults (20-39 years old) from 5 international populations: the Minneapolis Childhood Cohort Study, the Princeton Follow-up Study, the Bogalusa Heart Study, the Cardiovascular Risk in Young Finns Study, and the Childhood Determinants of Adult Health (CDAH) Study; all members of the International Childhood Cardiovascular Cohort (i3C) Consortium [7]. Results of the study showed that ideal CV health, as defined by the AHA, was rare among young participants of the study. An amazingly low (only 1%) percentage of the participants had all 7 health metrics in the 5,785 young adults participating from all international cohorts [7]. Many of the participants had ideal glucose (73%), cholesterol (64%), and were non-smokers (64%); diet (7%) was the least common metric for participants from any of the cohorts [7]. The lowest prevalence of a clinical CVD risk factor from the life's 7 simple was BP; this was normal in only 52% of the