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Published on: September 26, 2018
The challenge of choosing in cardiovascular risk management
R M Hoogeveen1, N M J Hanssen1, J R Brouwer2
1Department of Vascular Medicine, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.
Insights
Cardiovascular disease (CVD) management involves standard therapies and lifestyle changes. Novel treatments address residual risk, but choices depend on absolute CV risk and specific patient factors.
Area of Science:
- Cardiology
- Preventive Medicine
- Pharmacology
Background:
- Cardiovascular disease (CVD) remains a leading global cause of death.
- Established guidelines recommend optimal preventive therapies for CVD.
- Recent advancements offer novel therapeutic options for cardiovascular risk management (CVRM).
Purpose of the Study:
- To review therapeutic decisions in CVRM.
- To focus on patient's absolute cardiovascular risk.
- To evaluate the advantages and disadvantages of new treatment options.
Main Methods:
- Literature review of current guidelines and novel therapies.
- Analysis of risk stratification in CVRM.
- Discussion of drug combinations for residual CV risk reduction.
Main Results:
- Standard preventive medication and lifestyle modifications are effective for most CVD patients.
- A minority of patients require add-on therapies to manage high residual CV risk.
- Treatment decisions are complex, influenced by absolute CV risk and the etiology of high risk.
Conclusions:
- Optimizing CVRM requires a personalized approach.
- Understanding absolute CV risk is crucial for selecting appropriate therapies.
- Novel treatments offer additional benefits but necessitate careful consideration of patient-specific factors.
Abstract:
Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. For many years guidelines have listed optimal preventive therapy. More recently, novel therapeutic options have broadened the options for state-of-the-art CV risk management (CVRM). In the majority of patients with CVD, risk lowering can be achieved by utilising standard preventive medication combined with lifestyle modifications. In a minority of patients, add-on therapies should be considered to further reduce the large residual CV risk. However, the choice of which drug combination to prescribe and in which patients has become increasingly complicated, and is dependent on both the absolute CV risk and the reason for the high risk. In this review, we discuss therapeutic decisions in CVRM, focusing on (1) the absolute CV risk of the patient and (2) the pros and cons of novel treatment options.
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Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...