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Cardiovascular prevention: sometimes dreams can come true
Roberto Ferrari1, Paolo Cimaglia1, Anna Cantone1
1Cardiovascular Research Centre, Ferrara University, Via Aldo Moro 8, 44124 Ferrara, Italy.
Insights
Future cardiovascular disease (CVD) prevention requires a paradigm shift towards personalized, technology-driven strategies. This approach emphasizes proactive health management over reactive treatment, integrating genetic insights and environmental factors for better outcomes.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Cardiovascular disease (CVD) is a major chronic condition influenced by multiple factors, with prevention being key as treatments plateau.
- The COVID-19 pandemic highlighted limitations in current healthcare systems, especially in preventive medicine.
- Recent advancements include SCORE2 risk prediction algorithms and updated prevention guidelines.
Purpose of the Study:
- To envision a future model for cardiovascular disease (CVD) prevention.
- To explore innovative concepts and paradigms for proactive CVD risk management.
- To outline necessary steps for achieving an ideal CVD prevention system.
Main Methods:
- Review of current CVD prevention strategies and emerging technologies.
- Discussion of novel concepts such as genetically personalized risk factors and cardiac risk cartography.
- Analysis of the exposome and economic factors in CVD prevention.
Main Results:
- The current healthcare system needs to transition from a 'sick' to a 'healthy' model.
- Integration of advanced technologies is crucial for effective CVD prevention.
- A 'care health team' approach, acting as a 'clearing house', is proposed over traditional 'heart teams'.
Conclusions:
- A future-oriented, personalized, and technology-integrated approach is essential for effective CVD prevention.
- Shifting focus to a proactive, 'healthy' system is vital.
- Achieving this vision requires addressing specific, articulated points for systemic change.
Abstract:
Cardiovascular disease (CVD) is a chronic condition driven by the complex interaction of different risk factors including genetics, lifestyle, environment, etc. which, differently from other pathologies, can be prevented. Treatment of CVD has been inconceivably successful but now it seems that it has reached a plateau suggesting that prevention is the way forward. However, the COVID-19 pandemic has spotted all the limits of the actual health system regarding territorial and, particularly, of preventive medicine. To this end, recently, the SCORE2 risk prediction algorithms, a contemporary model to estimate 10 years risk of CVD in Europe and the new guidelines on prevention have been released. The present review article describes a dream: how prevention of CVD should be addressed in the future. New concepts and paradigms like early genetically personalized and imaging driven risk factors, cardiac risk cartography, measurements of the exposome, estimation of costs of a delayed outcome vs. healthy lifespan, are all addressed. We highlight the importance of technologies and the concept of being engaged in a 'healthy' and not just 'sick' system as it is today. The concept of 'clearing house' with a 'care health team' instead of a 'heart team' is described. Finally, we articulate the four points necessary for the dream to come true.
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