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Review
. 2024 Aug 1;31(8):1113-1128.
doi: 10.5551/jat.RV22019. Epub 2024 Jun 1.

Primary Prevention of Coronary and Other Cardiovascular Diseases: A Focused Review

Aya Higashiyama  1 , Shun Kohsaka  2 , Akira Fujiyoshi  1
Affiliations
Review

Primary Prevention of Coronary and Other Cardiovascular Diseases: A Focused Review

Aya Higashiyama et al. J Atheroscler Thromb. .

Abstract

In 2022, the Japan Atherosclerosis Society (JAS) updated its prevention guidelines, the "Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022" (JAS2022GL), expanding its scope from coronary artery disease (CAD) to atherosclerotic cardiovascular diseases (ASCVDs), including atherothrombotic stroke. The following year, the Japanese Circulation Society (JCS) updated its guidelines for primary prevention entitled "JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease" (JCS2023GL). Since those publications, scientific advancements in relevant fields have continued. This review article outlines the current recommendations provided by the guidelines, provides background information supporting these recommendations, introduces scientific findings subsequent to prior publications, and discusses future directions on select topics for the primary prevention of CVD. The topics covered in this review are traditional risk factors, including dyslipidemia and hypertension, the application of comprehensive risk stratification or risk scoring systems, patient-specific topics, salt and alcohol, and environmental factors. These topics were deliberate and selected by the authors, who were involved in the compilation of either or both JAS2022GL and JCS2023GL. This review not only emphasizes the pivotal role of continuously updated guidelines in shaping clinical practice but also stresses the urgent need for ongoing research to bridge existing knowledge and practice gaps.

Keywords: Environment; Hormone replacement therapy; JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease; Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022; Risk factor.

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Conflict of interest statement

Dr. Kohsaka received grants from Bristol-Myers Squibb, Novartis, and AstraZeneca outside the submitted work. The other authors declare that they have no conflict of interest.

Figures

Fig.1. Trend in age-adjusted total cholesterol (mg/dL) between 1980 and 2008 in select countries
Fig.1. Trend in age-adjusted total cholesterol (mg/dL) between 1980 and 2008 in select countries
(a) Men. (b) Women. Modified from Int J Epidemiol. 2015; 44: 1614-1624.
Fig.2. Self-reported treatment rate for dyslipidemia among individuals with serum LDL-C ≥ 180 mg/dL by sex
Fig.2. Self-reported treatment rate for dyslipidemia among individuals with serum LDL-C ≥ 180 mg/dL by sex
(a) Men. (b) Women. Source: Prepared from the Ministry of Health, Labour and Welfare. https://www.mhlw.go.jp/stf/newpage_26980.html
Fig.3. Flow of risk stratification for primary prevention of atherosclerotic cardiovascular disease (lower half)
Fig.3. Flow of risk stratification for primary prevention of atherosclerotic cardiovascular disease (lower half)
Footnote: ＊JAS2022GL encompasses not only CAD but also atherothrombotic stroke within its scope of prevention, collectively termed atherosclerotic cardiovascular diseases (ASCVD). Adapted from J Atheroscler Thromb, 2023; 30: 000-000. http://doi.org/10.5551/jat.GL2022
See this image and copyright information in PMC

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