Global approach to high-risk cardiovascular patients

Cardiovascular diseases are the leading cause of death worldwide. Hypertension, diabetes and dyslipemia are major cardiovascular risk factors, thus modulating genesis, progression, and severity of atherosclerosis. Coexistence of those risk factors further increase the cardiovascular risk of the patients. Most recently published guidelines on cardiovascular disease prevention recommend a strict and fast LDL cholesterol control. Nowadays, an increasing number of drugs are available for achieving the rigorous objective in a safe and effective way. These include multiple drugs from statins to monoclonal antibodies (as PCSK9 inhibitors) and also, the recently developed bempedoic acid and inclisiran. Triglycerides and HDL cholesterol have been a controversial topic in cardiology, eventually been related with ischemic events. In a society with an increasing life expectancy, the control of hypertension is mandatory as it has been independently related with an increased risk of cerebrovascular accidents, cognitive impairment, and the development of dementia. Diabetes mellitus is directly related with cardiovascular and cerebrovascular events. The use of GLP-1 agonists have decreased the risk of stroke and the new SGLT2 inhibitors transformed the heart failure treatment in diabetic and non-diabetic patients. An effective and fast control of these risk factors is necessary to prevent cardiovascular diseases and decrease the socioeconomic impact of them in our society. Keywords: cardiovascular diseases; risk factors; lipids; hypertension; Diabetes mellitus