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Updated: Jul 23, 2026
Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
[Primary prevention of cardiovascular diseases. Stepchild of internal medicine]
E Windler1, B-Chr Zyriax, F U Beil
1Zentrum für Innere Medizin, Universitätsklinikum Hamburg-Eppendorf. Prof.Windler@t-online.de
Insights
Preventive medicine, focusing on lifestyle changes like nutrition and exercise, is crucial for combating cardiovascular disease. Pharmacotherapy is only an adjunct to these fundamental primary prevention strategies.
Area of Science:
- Public Health
- Preventive Medicine
- Cardiovascular Disease Research
Background:
- Arteriosclerotic cardiovascular disease (ASCVD) remains a leading cause of mortality and morbidity.
- Current healthcare systems inadequately emphasize preventive medicine strategies.
- Risk factor modification is often pursued, but lifestyle factors are the underlying causes.
Purpose of the Study:
- To highlight the critical role of lifestyle changes in primary prevention of cardiovascular disease.
- To advocate for lifestyle modification as the cornerstone of preventive medicine.
- To underscore the limitations of solely focusing on risk factor correction.
Main Methods:
- Review of existing insights into ASCVD etiology.
- Analysis of intervention trial outcomes regarding risk factor modification.
- Identification of major societal risk factors: inadequate nutrition, physical inactivity, and smoking.
Main Results:
- Lifestyle factors are the root cause of major cardiovascular risk factors.
- Modifying lipid and carbohydrate metabolism or blood pressure shows effectiveness but has limitations.
- Plant-based diets, physical activity, and smoking cessation are key effective lifestyle changes.
Conclusions:
- Lifestyle correction is the true causal therapy for ASCVD prevention.
- Primary prevention should be based on lifestyle changes, with pharmacotherapy as an adjunct.
- Future medical and economic imperatives necessitate establishing lifestyle changes as the mainstay of medicine.
Abstract:
Preventive medicine has not been adequately established in our health care system. Despite growing in-sight into the causes underlying arteriosclerotic cardiovascular disease, half of the population dies and even more suffer from it. Generally the correction of risk factors is regarded as causal therapy. Modification of the lipid and carbohydrate metabolism or the blood pressure are certainly effective, however, intervention trials have also demonstrated the limitations. Mostly an unhealthy lifestyle underlies these risk factors so that correction of the lifestyle is the causal therapy in the true sense. That is the principle basis for primary prevention, while pharmacotherapy can only be an adjunct. Inadequate nutrition, physical inactivity and smoking are considered the true major risk factors in our society. Changes in nutrition in favor of plant products, some physical activity and refraining from smoking can serve an effective contribution to health. In the future not only medical, but also economic requirements will increasingly force us to establish prevention on the basis of lifestyle changes as a mainstay of medicine.
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