Cardiovascular Health vs Cardiovascular Risk A 2011 Update: Cardiovascular Risk Stratification, the Basis to Reach Therapeutic Goals

Enrique      C. Morales Villegas

Abstract

In this article, we review relevant concepts in Preventive Cardiovascular Medicine. Among the most important concepts analyzed are the following. Ideal Cardiovascular Health: A new construct proposed in 2010 by the American Heart Association (AHA) as a motivational concept, with the aim of communicating the ideal profile of cardiovascular health to the general public. Cardiovascular Risk Factors: In the absence of an ideal cardiovascular health profile in the 99.99% of adults, an objective cardiovascular risk evaluation is an obligated task and one that cannot be postponed by any physician. Cardiovascular Risk Stratification: Cardiovascular event prediction system elaboration, like the Framingham, is based on the incorporation and pondering of the predictive value of immutable variables as are age, gender and other mutable variables that are susceptible to treatment like: hypercholesterolemia, hypertension, hyperglycemia and smoker. These predictive systems allowed cardiovascular risk calculation to treat determining factors and decrease the statistic probability of a fatal or disabling cardiovascular event. Cardiovascular stratification and therapeutic goals: Age is the main risk factor for cardiovascular events, for instance, a man older than 45, or a woman older than 55, even with a blood pressure, total cholesterol and glucose in adequate levels and no smoker will have a calculated cardiovascular risk over 0.5% per year. Any stratification of the cardiovascular risk is not transcendental without a preventive-therapeutic action. Up-today and before the ATP-IV guidelines publication, therapeutic goals are established according to the cardiovascular risk level calculated with the Framingham method 2008. Beyond population approaches that are investigating massive treatments (poly-pill or polycap), and independently from cardiovascular risk stratification method employed, cardiovascular risk assessment is the clinical approach with the greatest impact in a medical practice, this enables to establish strategies to fulfill our most important goal as doctors, which is to show all individuals a way to have long lives and with quality of life.

Keywords: Cardiovascular health, cardiovascular risk, body mass index, Blood pressure, synergic modulators, C-reactive Protein, diabetes mellitus, emitting tomography