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Health Factors Associated with Cardiovascular Wellness

  • Evidence-Based Medicine, Clinical Trials and Their Interpretations (L. Roever, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

In this review, we discuss a new paradigm for atherosclerotic cardiovascular disease (ASCVD) prevention that is focused on cultivating cardiovascular wellness through the promotion of “health factors.”

Recent Findings

Cardiovascular prevention efforts have contributed to falling rates of ASCVD over the past five decades. However, contemporary increases in obesity and diabetes have led to a recent slowing in the annual decline of ASCVD death rates. This slowing represents an opportunity for new thinking to change the current ASCVD prevention paradigm, i.e., the identification and treatment or control of risk factors for disease. Indeed, a new paradigm focusing on cultivating cardiovascular wellness in addition to preventing disease is gaining increased traction. With this approach, the goal of ASCVD prevention is shifting to include consideration of both treating “risk factors” and cultivating health factors. Importantly, cardiovascular wellness is more than just the absence of disease and, therefore, risk factors and health factors are not always mere opposites.

Summary

We review healthy lifestyle tools such as the American Heart Association Life’s simple 7 and Fuster-BEWAT score. We summarize landmark studies of interventions aimed at improving adherence to health factors. We highlight the inherent limitations of current studies to adequately examine cardiovascular wellness. We propose new study designs that are required to identify novel health factors and measures of wellness. We conclude with recommendations regarding the utility of health factors and cardiovascular wellness in current practice.

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Notes

  1. Fruits and vegetables ≥ 4.5 cups per day. Fish: ≥ two 3.5-oz servings per week (preferably oily fish). Fiber-rich whole grains (≥ 1.1 g of fiber per 10 g of carbohydrate) ≥ 3 1-oz-equivalent servings per day. Sodium < 1500 mg per day. Sugar-sweetened beverages ≤ 450 kcal (36 oz) per week.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, University of Kansas School of Medicine, Wichita, KS, USA

    Mahmoud Al Rifai

  2. Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Mahmoud Al Rifai, Miguel Cainzos-Achirica, Michael J. Blaha, Kelly Arps, Roger S. Blumenthal & John W. McEvoy

  3. Bellvitge University Hospital and Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain

    Miguel Cainzos-Achirica

  4. Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK

    David A. Wood

  5. National University of Ireland, Galway Campus, Galway, Ireland

    David A. Wood & John W. McEvoy

  6. National Institute for Preventive Cardiology; and Saolta University Healthcare Group, University College Hospital Galway, Newcastle Rd, Galway, Ireland

    David A. Wood & John W. McEvoy

Authors
  1. Mahmoud Al Rifai
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  2. Miguel Cainzos-Achirica
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  3. Michael J. Blaha
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  4. Kelly Arps
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  5. David A. Wood
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  6. Roger S. Blumenthal
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  7. John W. McEvoy
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Corresponding author

Correspondence to John W. McEvoy.

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Conflict of Interest

Mahmoud Al Rifai, Miguel Cainzos-Achirica, Michael J. Blaha, Kelly Arps, David A. Wood, Roger S. Blumenthal, and John W. McEvoy declare no conflict of interest.

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Al Rifai, M., Cainzos-Achirica, M., Blaha, M.J. et al. Health Factors Associated with Cardiovascular Wellness. Curr Atheroscler Rep 21, 10 (2019). https://doi.org/10.1007/s11883-019-0771-0

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  • DOI: https://doi.org/10.1007/s11883-019-0771-0

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