SECONDARY PREVENTION AND RISK REDUCTION STRATEGIES FOR PATIENTS WITH CARDIOVASCULAR DISEASES

Each year, millions of people are admitted to hospitals and intensive care units following acute cardiovascular events. During their hospitalization, most of these patients receive immediate, adequate and effective care. Nevertheless, one cannot forget that these patients have high-level risk of developing a new cardiovascular event. Several sources (data from observational studies, the diagnosis at discharge, information about the specific treatments received, mortality data) indicate that, after discharge from the hospital, these patients are neither properly followed-up nor receive adequate treatments, even though a large body of evidence confirms the value and effectiveness of secondary prevention of cardiovascular events.

Therefore, it seems that even in this era of extensive programs focusing on prevention, in many cases of acute cardiovascular events secondary prevention is not fully and adequately implemented.

It is recognized that cardiovascular diseases have multiple causes (age, gender, hypertension, smoking habits, diabetes, hypercholesterolemia) and the coexistence of several risk factors increases the probability of occurrence of the condition. The degree of risk that each person has to develop a cardiovascular disease is linked to that person’s specific factors; moreover, the risk is continuous and increases with age. On the other hand, it has been demonstrated that cardiovascular risk is reversible: it is possible to decrease it or at least keep it at an acceptable level, by lowering the impact of the modifiable factors.

Relevant experimental evidence has been recently generated further supporting and broadening the merits of intensive risk-reduction therapies in patients with cardiovascular diseases, including atherosclerotic vascular disease and peripheral artery diseases. Evidence-based recommendations and guidelines for secondary cardiovascular prevention are now available and are taken as reference for clinical intervention. Radical changes in lifestyle including identification and containment of established risk factors (especially hypertension, smoking, dyslipidemia, diabetes, obesity or poor diet and physical inactivity) have been proven as beneficial and are viewed as key strategies for curbing the consequences and decreasing premature morbidity and mortality due to cardiovascular diseases. In addition, the administration of pharmacological therapies (such as aspirin, statins, anti-hypertensive drugs) has been demonstrated to be beneficial.

Secondary cardiovascular prevention should aim to reduce the risk of subsequent events, thus improving quality of life of these patients, extend their lifespan and minimize the need for intervention and procedures. The strong positive impact that innovative scientific and clinical research has brought to the field of secondary prevention and risk reduction strategies for patients with cardiovascular diseases must be recognized and acknowledged.