Cardio-metabolic risk prediction should be superior to cardiovascular risk assessment in primary prevention of cardiovascular diseases

Abstract

Cardiovascular atherosclerotic diseases represent the main cause of death in the developed and developing populations. Although major progress has been made in the management of the classical modifiable cardiovascular risk factors, unhealthy lifestyle conduces to an increasing prevalence of overweight, obesity, metabolic disorders, type 2 diabetes mellitus, premature atherosclerosis and cardiovascular diseases. That is why cardio-metabolic risk prediction should be superior in the primary prevention of atherosclerosis and cardiovascular diseases. Up-to-date primary preventive strategies according to the European Guidelines, especially the high risk strategy approach, are being implemented. Individual cardiovascular and better cardio-metabolic risk assessment represents the basic approach in the individualized primary prevention of cardiovascular diseases and type 2 diabetes mellitus. Cardio-metabolic biomarkers, especially high sensitivity C-reactive protein, albuminuria, N-terminal pro-brain natriuretic peptide, and imaging procedures (carotid intima-media thickness measured by ultrasound) could improve the prediction of cardiovascular diseases and type 2 diabetes beyond that using traditional risk factors.

Fig. 1

Mortality of ischemic heart disease in European and other countries [2]. CARK - 5 central Asian republics including Kazakhstan, CIS - 12 countries of the “Commonwealth of Independent States”, EU – European Union, Eur-A – Western European countries, Eur – B+C – Middle and Eastern European countries

Fig. 2

Prevalence of type 2 diabetes mellitus in European and other countries [2], CARK - 5 central Asian republics including Kazakhstan, CIS - 12 countries of the “Commonwealth of Independent States”, Eur – B+C – Middle and Eastern European countries

Fig. 3

SCORE - European Low Risk Chart [3]