CVD prevention offers positive long-term health benefits for patients of all ages
Currently CVD prevention in the young, or those with just a mild or moderate risk, is limited, but it can result in substantial benefits4. As atherosclerosis is a chronic, progressive disease usually initiated during the first 30 years of life, maintaining desirable LDL-cholesterol levels at an early stage, even from childhood, substantially delays or possibly prevents the onset of the disease7,9. This approach is associated with a markedly greater reduction in CVD risk than lowering already elevated LDL-cholesterol levels in middle age7,16. However, it should be considered never too late to take action to lower cholesterol levels.
So, how can LDL-cholesterol levels be maintained at optimal or desired levels throughout life without long-term drug use and adding to the burden on the healthcare system? Dietary habits and lifestyle factors need to be seriously considered; particularly as nutritional and behavioral changes have been shown to lower LDL-cholesterol levels by up to 20%17.
Cardiovascular disease is the result of a lifelong process and, as such, intervention strategies to reduce risk such as adopting a healthy diet and lifestyle should begin as early in life as possible
Dietary modifications should form the basis for CVD prevention
Furthermore, cohort studies demonstrate a clear link between a low total CVD risk profile (through lifestyle) and low CHD incidence. One example is a cohort study of 42,847 male US health professionals aged 40-75 years followed for a 16-year period during which a total of 2,183 incident coronary events were observed18. Results indicated that higher healthy lifestyle scores were associated with lower incidences of CHD. These low-risk scores were defined as:
- absence of smoking
- body mass index <25kg/m2
- moderate-to-vigorous physical activity 30min/d
- moderate alcohol consumption (5 to 30g/d)
- eating a healthy, balanced diet18
In fact, 62% of coronary events in this cohort may have been prevented with better adherence to these five healthy lifestyle practices18. Furthermore, among men taking medication for hypertension or hypercholesterolemia, 57% of all coronary events may have been prevented with a low-risk lifestyle18.
Test your knowledge
- Intervention strategies to reduce CVD risk should begin the earlier the better
- Intervention strategies to reduce CVD risk should begin after elevated LDL-cholesterol levels have been diagnosed
- Intervention strategies to reduce CVD risk should start in middle age independent of LDL-cholesterol levels