Authors |
Mozaffarian D, Wilson PW, Kannel WB. |
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Title |
Beyond Established and Novel Risk Factors Lifestyle Risk Factors for Cardiovascular Disease |
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Full source | Circulation 2008;117;3031-3038 | |
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Introduction |
Dyslipidemia,
hypertension, and diabetes mellitus have been appropriately highlighted
as established predictors of cardiovascular disease. These risk factors
have become preeminent targets for influencing cardiovascular risk; their
assessment, treatment, and monitoring are major emphases of clinical care,
research investigation, treatment guidelines, organization position papers,
and measures of physician and hospital performance. Notably, lifestyle
risk factors, including dietary habits, physical inactivity, smoking,
and adiposity, strongly influence the established cardiovascular risk
factors and also affect novel pathways of risk such as inflammation/oxidative
stress, endothelial function, thrombosis/coagulation, and arrhythmia.
Furthermore, modest alterations of these lifestyle risk factors are achievable
and have substantial effects on cardiovascular risk. Thus, basic lifestyle
habits should be considered fundamental risk factors for cardiovascular
disease. Although efforts to combat established and novel risk factors
with pharmacological treatments are important and should continue, we
call for a systematic rebalancing of current research, clinical care,
and policy efforts to focus more on lifestyle. The rising costs of healthcare
and the epidemics of overweight and obesity highlight the inadequacies
of our current strategy. Substantially more resources should be directed
toward research on lifestyle risk factors, their determinants, and effective
interventions to change them. The clinical evaluation and treatment of
dietary, physical activity, and smoking habits must become as routine
and familiar as assessment of blood pressure, cholesterol, and glucose
levels. Major policy initiatives and reimbursement guidelines must also
be rebalanced to emphasize lifestyle risk factors.
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