Cardiovascular Diseases: A 2016 Perspective

ABSTRACT

A review was made of the current literature on cardiovascular diseases. The following key findings were found (1) CVDs need to be reduced in Singapore and worldwide. (2) CVD risk assessment tools are population specific – use the FRS modified score for Singapore. (3) New ideas about therapeutic lifestyle change as primary prevention are to take note of the individuals who fail in lifestyle change early and to direct them to alternative strategies; educating patients to reduce sitting time, increasing physical activity, and cardio-respiratory fitness is beneficial; higher protein diets help in creating weight loss and reducing weight regain; trans fats are associated with all-cause mortality, total CHD, and CHD mortality. (4) Paradigm shifts in secondary prevention are statin treatment intensity recommended in the 2013 ACC/AHA cholesterol treatment guidelines; setting the blood pressure targets for patients with diabetes mellitus to be less than 140/90 mmHg; and noting that the older patient (beyond 70 to 74 years) with diabetes mellitus need to be managed as one would do so with a middle-aged patient. (5) The iCVH model as the 2020 impactful strategy for cardiovascular disease reduction for Americans provides food for thought as a potential Singapore strategy -- Promote in each patient especially the young patient, the simultaneous presence of optimal levels of 4 health behaviours (body mass index, physical activity, nonsmoking status, and diet quality) and reduction of 3 disease factors (total cholesterol, blood pressure, and fasting blood glucose).