Novel pathogenic insights in the primary prevention of cardiovascular disease

Epidemiologic studies clearly demonstrate that cardiovascular disease (CVD) has become a worldwide cause of morbidity and mortality in most countries, and a rise in CVD mortality rates in the developing countries for the next 25 years is expected. We provide a coherent path depicting the natural evolution of primary prevention paradigm from in utero fetal development to elderly, in which all preventive strategies to reduce CVD are applied. The efficiency of nitric oxide bioavailability and the reduction of vascular inflammation are relevant in the development of CVD. Established pharmacologic agents have improved the prognosis of CVD, but several new strategies to reduce the long-term risk of CVD are needed. Stem cell therapy strategies have been evaluated for the treatment of CVD. Bone marrow and endothelial progenitor cells have been most extensively studied, suggesting that this approach may have beneficial effects on cardiac function.