Cardiovascular risk and atherosclerosis prevention

Area of Science:

• Cardiovascular Medicine
• Preventive Cardiology
• Biomarker Research

Background:

• Coronary artery disease (CAD) was a leading cause of death, but mortality has significantly declined.
• Improved understanding of major risk factors, including apolipoprotein (apo) B/apo A1 ratio, smoking, diabetes, and hypertension, has driven this reduction.
• Existing risk assessment algorithms have limitations due to varying populations, study ages, and scoring parameters.

Purpose of the Study:

• To review current strategies for CAD risk assessment and prevention.
• To highlight the importance of biomarkers beyond traditional lipid profiles, such as apolipoproteins and lipoprotein (a) [Lp(a)].
• To emphasize the role of lifestyle modifications and pharmacotherapy in managing CAD risk.

Main Methods:

• Review of existing literature on CAD risk factors, assessment tools, and prevention strategies.
• Discussion of traditional risk factors and emerging biomarkers.
• Analysis of the components of effective CAD management, including lifestyle changes and medications.

Main Results:

• The apo B/apo A1 ratio is a critical risk factor, alongside smoking, diabetes, and hypertension.
• Lipoprotein (a) [Lp(a)] is identified as an independent, atherogenic, and prothrombotic risk factor for CAD.
• Current prevention strategies, incorporating lifestyle changes (smoking cessation, weight management, exercise, diet) and medications (lipid-lowering, anti-hypertensive, anti-coagulant), have led to a >50% decrease in CAD mortality.

Conclusions:

• Risk assessment for CAD requires consideration of diverse populations and evolving biomarkers.
• Lifestyle interventions and pharmacotherapy are cornerstones of effective CAD prevention and management.
• The decline in CAD mortality underscores the success of integrated risk factor management strategies.