Editorial
Volume 3 Issue 2 - 2020
Prevention of Acute Vascular Events: Precision, Personal, and Conventional Medicine
Gundu HR Rao*
Emeritus Professor, Laboratory Medicine and Pathology, Director, Thrombosis Research, Lillehei Heart Institute, University of Minnesota, USA
*Corresponding Author: Gundu HR Rao, Emeritus Professor, Laboratory Medicine and Pathology, Director, Thrombosis Research, Lillehei Heart Institute, University of Minnesota, USA.
Received: November 28, 2019; Published: January 01, 2020




Cardiovascular diseases (CVDs) are the number one cause of death globally, taking an estimated 18 million lives each year. Four out of 5 CVD deaths are due to heart attacks and strokes and one third of these deaths occur prematurely in people under 70 years of age. In a ‘Hot Line Session’ at the European Society of Cardiology Congress- 2019, PURE study results on the causes of death due to CVD were announced. Professor Salim Yusuf, senior author of the study and Principal Investigator of PURE clinical trials, said: “The high rates of cardiovascular disease and related mortality in low-income countries are likely related to gaps in access to, or availability of, healthcare”. INTEHEART study of potentially modifiable risk factors associated with myocardial infarction in 52 countries showed that abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychological factors, consumption of fruits, vegetables and alcohol, and regular physical activity account for most of the risk for myocardial infarction worldwide in both sexes and at all ages in all regions. The authors concluded that, “This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infraction [1]. Khera and associates from the Harvard University, working on risk factor management for CVDs, concluded, “Across studies involving 55,685 participants, genetic and lifestyle factors were independently associated to coronary artery disease. Even among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease, than was an unfavorable lifestyle [2]. The World Health Organization (WHO) estimates, that over 75% of premature CVD is preventable and risk factor amelioration can help reduce the growing CVD burden. Furthermore, primary prevention of CVD is of particular interest, as developing countries experience a greater burden of these metabolic diseases and can be prevented by careful modifiable risk reduction.

References

  1. Yusuf S., et al. “Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study”. Lancet 364.9438 (2004): 937-952.
  2. Khera AV., et al. “Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease”. New England Journal of Medicine 375 (2016): 2349-2358.
  3. Huffman MD., et al. “Implementation Strategies for Cardiovascular Polypills”. Journal of the American Medical Association (2019). 
  4. Joyner MJ and Paneth N. “Cardiovascular Disease Prevention at a Crossroads: Precision Medicine or Polypill?” Journal of the American Medical Association (2019). 
  5. Gelbenegger G., et al. “Aspirin for primary prevention of cardiovascular disease: a meta- analysis with a particular reference on subgroups”. BMC Medicine 17.1 (2019): 198.
  6. Collins F and Varmus H. “A New Initiative on Precision Medicine”. New England Journal of Medicine 372.9 (2015): 793-795.
  7. Marks WJ. “Drug regulation in the area of individualized therapies”. New England Journal of Medicine 381.17 (2019): 1678-1680.
  8. Kim J., et al. “Patient-customized Oligonucleotide therapy for a rare genetic disease”. New England Journal of Medicine 381.17 (2019): 1644-1652.
  9. Basu S., et al. “Health and Economic Implications of National Treatment Coverage for Cardiovascular Disease in India”. Circulation: Cardiovascular Quality and Outcomes 8.6 (2015): 541-551.
  10. Leopold JA and Loscalzo J. “The Emerging Role of Precision Medicine in Cardiovascular Disease”. Circulation Research 122.9 (2018): 1302-1315. 
  11. Lee M., et al. “Personalized Medicine in Cardiovascular Diseases”. Korean Circulation Journal 42.9 (2012): 583-591.
Citation: Gundu HR Rao. “Prevention of Acute Vascular Events: Precision, Personal, and Conventional Medicine”. EC Clinical and Medical Case Reports 3.2 (2020): 01-03.

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