Canadian Journal of Cardiology

Importance of Optimization of Cardiovascular Risk Factors and Lifestyle Behaviours

  • Todd J. Anderson
    Correspondence
    Corresponding author: Dr Todd J. Anderson, 1403 29th St NW, Calgary, Alberta T2N-2T9, Canada. Tel.: +1-403-944-1033; fax: +1-403-944-1592.
    Affiliations
    Libin Cardiovascular Institute and Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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      The concept of atherosclerotic cardiovascular disease (ASCVD) risk factors began with the establishment of community-based cohort studies such as the Framingham Heart Study in the late 1940s.
      • D'Agostino Sr., R.B.
      • Vasan R.S.
      • Pencina M.J.
      • et al.
      General cardiovascular risk profile for use in primary care: the Framingham Heart Study.
      This notion was established by following healthy individuals over a period of years and demonstrating that certain modifiable and nonmodifiable factors were present more often in those who experienced myocardial infarction, stroke, or cardiovascular death. Some of these factors were related to unhealthy lifestyle choices, such as cigarette smoking, whereas others may have been related to a combination of genetic and environmental factors. This would include blood pressure, lipoprotein, and glucose levels. The INTERHEART study, a standard case-control study of myocardial infarction determinants in 52 countries, found that 9 potentially modifiable risk factors accounted for more than 90% of the population attributable risk.
      • Yusuf S.
      • Hawken S.
      • Ounpuu S.
      • et al.
      Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study.
      Given the striking heterogeneity of cardiovascular prevalence across the globe, it is believed that the vast majority of ASCVD could be eliminated with appropriate adherence to risk factor interventions.
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