Epidemiology and prevention of cardiovascular disease

Cardiovascular diseases (CVDs) including coronary artery disease, stroke, heart failure, peripheral arterial disease, and other CVD manifestations comprise the leading causes of morbidity and mortality worldwide. Key risk factors, including hypertension, cigarette smoking, elevated cholesterol, elevated glucose levels/diabetes, obesity, and physical inactivity comprise the top six leading causes of death globally. Prevention of CVD focuses on identifying and managing these and other key risk factors at both the population and individual level through approaches aimed at primordial, primary, and secondary prevention. Global risk factor assessment with short or long-term risk prediction algorithms can help identify those most appropriate for treatment. Novel risk factor evaluation and screening for subclinical CVD can also help further stratify CVD risk. Clinical trials have documented the efficacy of key interventions, including those involving antiplatelet, blood pressure, and lipid modification (from statins and newer non-statin therapies), as well as newer diabetes treatments that reduce CVD risk. Future efforts will best determine what combination of interventions at both the population and individual level can have the greatest impact on prevention of CVD.