[Primary and secondary prevention of the acute coronary syndrome]
1Klinik und Poliklinik Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar.
Insights
Preventing coronary heart disease (CHD) and acute coronary syndrome (ACS) is possible by managing conventional risk factors like smoking and high blood pressure. Lifestyle changes and risk factor control significantly improve outcomes for cardiovascular disease patients.
Area of Science:
- Cardiology and Public Health
- Epidemiology of Cardiovascular Diseases
Context:
- Coronary heart disease (CHD) and acute coronary syndrome (ACS) are leading causes of mortality in Germany.
- Conventional risk factors (smoking, hypertension, hypercholesterolemia, diabetes) explain over 80% of cardiovascular diseases (CVDs).
Purpose:
- To emphasize the potential for cardiovascular disease prevention through risk factor management.
- To highlight the importance of global vascular risk assessment for personalized treatment strategies.
- To outline primary and secondary prevention guidelines for acute coronary syndrome.
Summary:
- Prospective studies indicate that cardiovascular diseases are largely preventable by addressing established risk factors.
- Risk scores are crucial for estimating individual global vascular risk, identifying patients benefiting from targeted medical interventions (blood pressure, lipid, and platelet aggregation control).
- Strict secondary prevention guidelines are essential for patients with existing CVDs, arteriosclerosis, or diabetes, with lifestyle modification and risk factor control being paramount.
Impact:
- Implementing comprehensive risk factor management and lifestyle changes can improve quality of life and prognosis for patients at risk of or with cardiovascular disease.
- Early identification of high-risk individuals through risk scoring facilitates timely and effective medical interventions.
Abstract:
Coronary heart disease and the acute coronary syndrome are the leading causes of death in Germany. In prospective observational studies conventional risk factors such as smoking, arterial hypertension, hypercholesterolaemia, and diabetes can explain over 80% of cardiovascular diseases. Therefore, cardiovascular diseases are potentially preventable. The basis of a rational primary prevention is a thorough estimation of the global vascular risk. The application of risk scores allows an estimation of a person's global vascular risk. Furthermore, the estimation of an individual global vascular risk enables to identify patients who profit from an additional medical treatment to control blood pressure, lipids, and platelet aggregation. Besides general preventive measures, strict guidelines for secondary prevention are pre-eminent for patients with known coronary heart disease, documented arteriosclerosis in other vascular regions or known diabetes. Patients with an acute coronary syndrome are at an increased risk. Therefore, guidelines for these patients are very strict. In general, the following applies to primary and secondary prevention of the acute coronary syndrome: Change in lifestyle and strict risk factor control improve the quality of life and prognosis when followed consequently.
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