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Published on: September 26, 2018
Differences in the prevention and control of cardiovascular and cerebrovascular diseases
Chengdi Liu1, Lida Du2, Shoubao Wang1
1Beijing Key Laboratory of Drug Target Identification and Drug Screening, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China.
Insights
Preventing cardiovascular diseases (CAVDs) shows progress, but cerebrovascular diseases (CEVDs) lag behind. Low-dose aspirin is more effective for CAVDs than CEVDs primary prevention, highlighting a need for better CEVDs strategies.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Cardiovascular disease (CAVD) prevention has advanced, while cerebrovascular disease (CEVD) prevention requires improvement.
- Existing strategies often overlook the unique pathological and physiological aspects of CEVDs compared to CAVDs.
- Misconceptions persist regarding unified control methods and drug efficacy for both disease types.
Purpose of the Study:
- To analyze and compare the prevention and control of CEVDs and CAVDs.
- To evaluate the differential efficacy of low-dose aspirin in primary prevention for CEVDs and CAVDs.
- To identify gaps and misunderstandings in current CEVD prevention strategies.
Main Methods:
- Literature review of CEVD and CAVD prevention strategies.
- Meta-analysis of low-dose aspirin's primary prevention effects on CEVDs and CAVDs.
- Comparative analysis of pathological and physiological structures.
Main Results:
- Low-dose aspirin demonstrates greater efficacy in the primary prevention of CAVDs than CEVDs.
- Significant differences exist in effective prevention measures and drugs for CEVDs versus CAVDs.
- Current CEVD prevention overlooks cerebrovascular protection, focusing predominantly on platelets.
Conclusions:
- There is a critical need for specialized preventive drugs for CEVDs, addressing blood, vascular endothelium, and blood-brain barrier protection.
- Current prevention approaches for CEVDs are insufficient and require optimization.
- Future drug discovery should focus on the unique requirements for CEVD prevention.
Abstract:
At present, the prevention and control of cardiovascular diseases (CAVDs) has made initial advancements, although the prevention and control of cerebrovascular diseases (CEVDs) has not yet achieved the desired progress. In this paper, we review the prevention and control of CEVDs and CAVDs, and analyze the differences in prevention effects, and the pathological and physiological structures pertaining to CEVDs and CAVDs. Combined with the different effects of low-dose aspirin in the primary prevention of CEVDs and CAVDs by meta-analysis, aspirin plays a more important role in the primary prevention of CAVDs than CEVDs. We recognize the misunderstandings and blind spots concerning prevention and control of CEVDs, which can be summarized as follows: (1) CEVDs and CAVDs can be controlled by the same methods and drugs; (2) considering the same pathological factors for cardiovascular diseases; (3) a lack of understanding of the particularity of CEVDs; (4) a focus on platelets and neglect of cerebrovascular protection. In summary, our research clarifies the differences in the prevention measures and drugs used for CEVDs and CAVDs. Of particular concern is the serious lack of preventive drugs for CEVDs in clinical use. An ideal drug for the prevention of CEVDs should have protective effects on the blood, the vascular endothelium, the blood-brain barrier (BBB), and other related factors. Our review aims to highlight several issues in the current prevention of CEVDs and CAVDs, and to provide an optimized plan for preventive drug discovery.
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