Atherosclerosis (ASVD) remains a leading driver of cardiovascular disease (CVD), a global health challenge that claims millions of lives each year. But what if prevention could rewrite the narrative?
Explore actionable, evidence-based strategies to combat traditional and emerging risk factors, with a focus on precision approaches and primordial prevention.
Precision Medicine: Personalizing Prevention for Better Outcomes
Precision medicine provides tools to customize prevention and treatment plans based on individual risk factors. Key strategies include:
Polygenic Risk Scores: Identifying Risk Early PRS helps identify young adults at high lifetime risk for coronary artery disease (CAD). Studies, such as those published in JACC (2022), show that early identification can lead to targeted interventions, reducing long-term risk.
LDL Management: The “Lower for Longer” Approach Research consistently supports the mantra, “Lower for Longer is Better.” A 2022 study published in Circulation demonstrated that earlier LDL-C reduction leads to compounded cardiovascular benefits over time. Practical steps include using statins or newer lipid-lowering therapies in patients identified as high-risk.
Targeting Inflammation: The Next Frontier in Prevention Novel therapies, such as interleukin-6 (IL-6) inhibitors, have shown promise in reducing residual inflammatory risk in patients already managing lipid-related risk factors. The RESCUE trial (2021) demonstrated that IL-6 inhibition significantly reduced high-sensitivity C-reactive protein (hs-CRP), a marker of inflammation linked to CVD events.
Primordial Prevention: Building a Foundation for Lifelong Heart Health
Starting prevention efforts early in life is key to reducing the lifetime burden of CVD. Practical strategies include:
Environmental Changes: Designing Healthier Communities Neighborhoods with sidewalks and bike paths can encourage physical activity, reducing obesity rates and improving cardiovascular health.
School-Based Interventions: Creating Healthy Habits Early Programs that limit sugar-sweetened beverages and increase physical education very likely reduce childhood obesity. Schools are critical venues for instilling healthy habits that persist into adulthood.
Policy Advocacy: Supporting Prevention on a Broader Scale Public health policies to reduce environmental risk factors (e.g., air pollution) and promote healthy food environments can support broader prevention efforts.
Overcoming Barriers: Making Prevention Accessible for All
Healthcare professionals can address systemic barriers to prevention with the following approaches:
Precision Therapies: Increasing Adherence Through Personalization Targeting therapy to reduce polypharmacy improves adherence. The right drug to the right person at the right time at the right dose!
Promoting Equity: Ensuring Care for Underserved Populations Collaborating with policymakers to ensure affordable access to therapies in underserved regions. For example, subsidized statins or lipid-lowering drugs can significantly reduce LDL levels in low-income populations.
Building Trust: Fighting Misinformation with Facts Clear, evidence-based communication about the benefits of prevention can combat misinformation and resistance.
Addressing Emerging Risks: Staying Ahead of CVD
Emerging contributors to CVD, such as Clonal hematopoiesis of indeterminate potential (CHIP) and the exposome, require further research. However, healthcare professionals can take actionable steps now:
Educate patients on the importance of minimizing environmental exposures, such as avoiding polluted areas or reducing indoor air pollutants.
Support clean energy policies that target major sources of cardiovascular risk, such as industrial emissions.
The Way Forward: Turning Research into Real-World Change
The fight against atherosclerosis requires proactive, evidence-based action. Precision medicine, primordial prevention, and addressing systemic barriers can improve outcomes and reduce the burden of CVD globally. With a clear focus on practical solutions, healthcare professionals can close the gap between research and real-world impact.