How to prolong the lives of our patients in health?
And is it possible?

Česká verzia

Authors: Aleš Linhart
Authors place of work: II. interní klinika kardiologie a angiologie, Komplexní kardiovaskulární centrum VFN a 1. LF UK Praha
Published in the journal: Vnitř Lék 2021; 67(2): 125-129
Category:

Summary

Recent data suggest that cardiovascular diseases are treatable but not curable. We are prolonging our patients lives, unfortunately not their life years spent in health. As shown by the British BioBank trial a longstandingexposition to genetically determined low LDL substantially lower cardiovascular risk. This is particularly relevant considering that modern medicinemakes possible to detect and safely intervene these risk factors in a timely fashion. This approach should be able to prevent early vascular aging. These methods should be applies in patients early after detection of high blood pressure and hypercholesterolemia and treat them to target levels. This approach my be particularlyrewarding in a well informed patient considering the mutual potentiation of multiple risk factors.

Keywords:

early vascular aging – arterial hypertension – Hypercholesterolemia

Zdroje

1. Ference BA, Bhatt DL, Catapano AL et al. Association of Genetic Variants Related to Combined Exposure to Lower Low‑Density Lipoproteins and Lower Systolic Blood Pressure With Lifetime Risk of Cardiovascular Disease. JAMA. 2019; 322(14): 1381–1391.

2. Laurent S, Boutouyrie P, Cunha PG et al. Concept of Extremes in Vascular Aging. Hypertension. August 2019. 17; 2: 218–228.

3. Williams B, Mancia G, Spiering W et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension [published correction appears in J Hypertens. 2019 Jan;37(1):226]. J Hypertens. 2018; 36(10): 1953–2041.

4. Williams B, Mancia G, Spiering W et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension. European Heart Journal. 2018. 39: 3021–3104.

5. Jackson R, Lawes CM, Bennett DA, Milne RJ, Rodgers A. Treatment with drugs to lower blood pressure and blood cholesterol based on an individual’s absolute cardiovascular risk. Lancet. 2005; 365(9457): 434–441.

6. Mach F, Baigent C, Catapano AL et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020; 41(1): 111–188.

7. Chhatriwalla AK, Nicholls SJ, Wang TH et al. Low levels of low‑density lipoprotein cholesterol and blood pressure and progression of coronary atherosclerosis. J Am Coll Cardiol. 2009; 53(13): 1110–1115.

8. Emberson J, Whincup P, Morris R, Walker M, Ebrahim S. Evaluating the impact of population and high‑risk strategies for the primary prevention of cardiovascular disease. Eur Heart J. 2004; 25(6): 484–491.

9. Kotseva K, De Backer G, De Bacquer D et al. Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC‑EORP EUROASPIRE V registry. Eur J Prev Cardiol. 2019; 26(8): 824–835.