Take Heart, Part I: Understanding behavioural CVD risk factors and methods of prevention give us reasons for optimism
Cardiovascular disease (CVD) remains a leading health concern: CVD causes 45% of all deaths in Europe; it is estimated that more than 11 million new cases of CVD will be diagnosed in Europe every year.1 However, looking at the future of CVD care, we find reasons for hope: we understand CVD better than ever before, we know who is especially at risk for CVD, and we know how to help prevent CVD.1, 2
A 48-year-old woman with high blood lipid levels. A 74-year-old woman who has smoked since she was young. A 62-year-old man who knows he needs to control his high blood pressure but can’t seem to manage it. And a middle-aged man who is constantly stressed and compensates for it with a bad diet. They come from all walks of life, all types of families, and all around the world. They couldn’t be more different.* But they have one thing in common: all are at risk for CVD.2
CVDs are a wide-ranging category of diseases that affect the heart and various blood vessels, including those that supply blood to the heart muscle (coronary heart disease), those that supply blood to the brain (cerebrovascular disease), and those that supply blood to the arms and legs (peripheral arterial disease).3 CVD includes atrial fibrillation (AF), which is the most common form of heartbeat arrhythmia and one of the major causes of stroke, heart failure, and cardiovascular morbidity. 4,5 Deep vein thrombosis (DVT), in which a clot forms in a deep vein, most often in the leg, is also a CVD.6 DVT can lead to pulmonary embolism, during which the clot moves from the leg to the lungs.3 Heart attacks (when blood flow to the heart becomes blocked) and strokes (when blood flow to the brain becomes blocked) are life-threatening emergencies that are often the result of CVD.7,8 These are just some of the most common CVDs that exist. Healthcare providers can help patients navigate CVDs and typically screen for a variety of factors that increase CVD risk in their patients.
CVD risk factors generally fall into two categories: behavioural and physiological.9 As the name implies, behavioural risk factors deal with the behaviour a person engages in, while physiological risk factors involve physical diseases of the body.9 Behavioural risk factors are quite suggestive for developing CVD and include smoking status, unhealthy diet, sedentary lifestyle, and excessive alcohol use.1,10 Some physiological markers (i.e. blood lipid levels that result from genetics) may not have a behavioural source; however, behavioural risk factors often materialise as physiological markers that a healthcare provider can identify: hypertension (high blood pressure), obesity, high blood cholesterol levels, and diabetes.2,10 Someone may also have physiological risk factors (genetics, family history) that are unrelated to behavioural risk factors.2 Physiological risk factors will be examined more deeply in a second article regarding CVD risk factors and prevention coming next month.
For behavioural risk factors, the key to CVD prevention lies in addressing those risk factors.10 Successfully dealing with risk factors in this context means examining and correcting the lifestyle behaviours and patterns that have become unhealthy habits. Eating habits are a major aspect of CVD risk, and a diet rich in plant-based foods, fruits, vegetables, nuts, fish, and fiber is encouraged, while red meat, salt, saturated fatty acids/trans saturated fatty acids, alcohol, and sugary beverages are discouraged.2 Smoking status is a decisive factor in developing CVD; simply quitting is an incredibly effective way to lower a person’s risk.2 Finally, regular exercise (including walking) comes with a multitude of positive health benefits, including lower risk of CVD and lower risk of diabetes.2
Habits that have been learned over a whole life are not easy to alter, but small, consistent change is attainable and can mean major progress over time. Many cases of CVD are preventable, which is why we at Daiichi Sankyo focus on the importance of understanding and identifying risk factors with the medical and scientific communities to support better patient outcomes. At Daiichi Sankyo, we care for every heartbeat, and we want you to take heart: CVD prevention through limiting behavioural risk factors is a goal that anyone can achieve with support and determination.
*These are example profiles that illustrate the risk factors described in the 2021 ESC Guidelines.