Banach Maciej, Toth Peter P, Bielecka-Dąbrowa Agata, Lewek Joanna
Faculty of Medicine, The John Paul II Catholic University of Lublin, Lublin, Poland.
Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Łódź, Poland.
Kardiol Pol. 2024;82(12):1200-1210. doi: 10.33963/v.phj.103997.
Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide with 20 million deaths annually. Recent advances in both primary and secondary prevention strategies have shown promising results in reducing the incidence and recurrence of cardiovascular events, but a question of fundamental importance is whether we are effective enough when predicting risk only in those over 40 years of age and only for 10 years. A similarly important question concerns the pathophysiological border between primary and secondary prevention and whether we should reorient our focus to atherosclerosis prevention as a continuous process that becomes clinically apparent later in life. The landscape of CVD prevention is rapidly evolving, with significant advancements in pharmacological treatments, technological innovations, and such lifestyle modifications as adopting a healthy diet, engaging in regular physical activity (PA), ensuring quality sleep, and quitting smoking, being crucial in the prevention of coronary artery disease. Integrating these strategies into clinical practice can enhance the effectiveness of both primary and secondary prevention, ultimately reducing the global burden of cardiovascular disease. This review highlights the latest developments and strategies aimed at diagnosis and preventing CVD. Key areas of focus include the use of novel agents and the role of digital health tools in improving both long-term patient adherence to evidence-based interventions and outcomes. The integration of these advancements into clinical practice has the potential to significantly enhance cardiovascular health and reduce the global burden of CVD.
心血管疾病（CVD）仍然是全球发病和死亡的主要原因，每年有2000万人死亡。一级和二级预防策略的最新进展在降低心血管事件的发生率和复发率方面显示出了令人鼓舞的结果，但一个至关重要的问题是，我们仅对40岁以上人群预测风险且仅预测10年时，是否足够有效。一个同样重要的问题涉及一级预防和二级预防之间的病理生理界限，以及我们是否应将重点重新转向将动脉粥样硬化预防作为一个在生命后期才在临床上显现的连续过程。心血管疾病预防的格局正在迅速演变，药物治疗、技术创新以及诸如采用健康饮食、定期进行体育活动（PA）、保证优质睡眠和戒烟等生活方式的改变在预防冠状动脉疾病方面至关重要。将这些策略整合到临床实践中可以提高一级和二级预防的有效性，最终减轻全球心血管疾病负担。本综述重点介绍了旨在诊断和预防心血管疾病的最新进展和策略。重点关注的关键领域包括新型药物的使用以及数字健康工具在提高患者长期坚持循证干预措施和改善结局方面的作用。将这些进展整合到临床实践中有可能显著增强心血管健康并减轻全球心血管疾病负担。
