“An apple a day keeps the doctor away”. But the saying seems true even once the doctor
already did his job. The recent AHA/ACC guidelins on the primary prevention of cardiovascular
diseases [
[1]
] and convincing new clinical studies on mortality reduction with physical activity
in patients with and without cardiovascular disease (CVD) [
[2]
] are imposing a view conferring to lifestyle and behavior interventions the dignity
of a measure not inferior to the pharmacological one and free of any harm. Yet even
in western countries the optimal use of these resources is far away due to barriers
being largely of a cultural nature. The Euroaspire III [
[3]
] and V studies [
- Kotseva K.
- Wood D.
- De Backer G.
- De Bacquer D.
- Pyörälä K.
- Reiner Z.
- Keil U.
EUROASPIRE Study Group. EUROASPIRE III
Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries.
Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries.
Eur J Cardiovasc Prev Rehabil. 2010; 17: 530-540
[4]
] have dramatically demonstrated in subjects still free from cardiovascular disease
that physical activity is practiced by no more than 20%; 17% currently smoke and 35%
are obese but also the majority of coronary patients do not achieve the guideline
standards for secondary prevention with high prevalences of persistent smoking, unhealthy
diets, physical inactivity. Poor patient awareness of the benefits of a healthy lifestyle
but also insufficient action from doctors for their patients in following the right
approach are still important barriers [
- Kotseva K.
- De Backer G.
- De Bacquer D.
- Rydén L.
- Hoes A.
- Grobbee D.
- Maggioni A.
- Marques-Vidal P.
- Jennings C.
- Abreu A.
- Aguiar C.
- Badariene J.
- Bruthans J.
- Castro Conde A.
- Cifkova R.
- Crowley J.
- Davletov K.
- Deckers J.
- De Smedt D.
- De Sutter J.
- Dilic M.
- Dolzhenko M.
- Dzerve V.
- Erglis A.
- Fras Z.
- Gaita D.
- Gotcheva N.
- Heuschmann P.
- Hasan-Ali H.
- Jankowski P.
- Lalic N.
- Lehto S.
- Lovic D.
- Mancas S.
- Mellbin L.
- Milicic D.
- Mirrakhimov E.
- Oganov R.
- Pogosova N.
- Reiner Z.
- Stöerk S.
- Tokgözoğlu L.
- Tsioufis C.
- Vulic D.
- Wood D.
EUROASPIRE Investigators
Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European society of cardiology esc-eorp euroaspire V registry.
Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European society of cardiology esc-eorp euroaspire V registry.
Eur J Prev Cardiol. 2019; 26: 824-835
[5]
,
[6]
]. And this is all the more serious the more clearly the benefit of healthy living
habits emerges with the guidelines that are defining better and better how to adopt
them.Keywords (MeSH)
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References
- ACC/AHA guideline on the primary prevention of cardiovascular disease: Part 1, lifestyle and behavioral factors.JAMA Cardiol. 2019; (2019 Jul 31)
- Mortality reduction with physical activity in patients with and without cardiovascular disease.Eur Heart J. 2019; 0: 1-9
- Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries.Eur J Cardiovasc Prev Rehabil. 2010; 17: 530-540
- Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European society of cardiology esc-eorp euroaspire V registry.Eur J Prev Cardiol. 2019; 26: 824-835
- Physical activity in patients with type 2 diabetes and hypertension–insights into motivations and barriers from the mobile study.Vasc Health Risk Manag. 2015; 11: 361-371
- General practitioner barriers to prescribe physical activity: The dark side of the cluster effects on the physical activity of their type 2 diabetes patients.PLoS ONE. 2015; 10e0140429
- How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure.Br J Sports Med. 2019; 53: 859-869
- Abstract P388.Presented at: The American heart association's joint hypertension scientific sessions. Chicago, 2018
- Long-term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study.BMJ Open. 2017; 7e013763
- Prospective urban rural epidemiology (PURE) study investigators. associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.Lancet. 2017; 390: 2050-2062
- European guidelines on cardiovascular disease prevention in clinical practice: The sixth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the european association for cardiovascular prevention & rehabilitation (EACPR).Eur Heart J. 2016; 2016: 2315-2381
- Yong CM; physical activity committee of the council on lifestyle and cardiometabolic health; council on clinical cardiology; council on epidemiology and prevention; Council on functional genomics and translational biology; and stroke council.Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association. Circulation. 2016 Sep 27; 134: e262-e279
Article info
Publication history
Published online: October 31, 2019
Accepted:
October 17,
2019
Received:
October 11,
2019
Identification
Copyright
© 2019 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
