Primary prevention of cardiovascular disease

Abstract

Cardiovascular disease (CVD) remains the leading cause of death in the United States and is largely preventable through lifestyle modifications and risk factor control. Primary prevention seeks to prevent disease in otherwise asymptomatic individuals. CVD risk factors may be classified as non-modifiable risk factors (age, gender, and family history) and modifiable risk factors (smoking, hypertension, dyslipidemia, obesity, inactivity, and diabetes). Primary prevention of CVD relies heavily on lifestyle modifications and aggressive treatment of risk factors such as hypertension and dyslipidemia. Global risk score prediction models include the Framingham Risk Score (FRS) that evaluates the 10-year risk of developing coronary heart disease in adults. Limitations of the FRS include underestimation of risk in certain populations and not accounting for lifetime CVD risk. More recently, novel cardiovascular risk factors such as high-sensitivity C-reactive protein (hs-CRP) have been shown to have additional predictive power for CVD events beyond that of traditional risk factors. In addition to targeting high-risk individuals for improved risk factor control, primary prevention relies on population-based approaches to shift the population distribution towards greater CVD health.