Effective Strategies and a Ten-Point Plan for Cardio-Kidney-Metabolic Health in Croatia: An Expert Opinion

Abstract

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide, including in Croatia. Since most patients have multiple disorders and diseases caused largely by the same risk factors, and as it is essential to approach each patient as a person with all disorders, today, we are talking about a new paradigm-cardio-renal-metabolic (CKM) syndrome and cardio-renal-metabolic health, which necessarily includes brain health. Elevated systolic blood pressure, LDL cholesterol, smoking, obesity, diabetes, impaired renal function or chronic kidney disease, which all stem from insufficient physical activity, an unhealthy diet with excessive intake of table salt, and air pollution, are the leading causes of overall morbidity and mortality from CKM diseases, especially mortality from CVD. Experts from various fields key to CKM health have written this document with the aim of integrating it as part of the national plan for the prevention of chronic non-communicable diseases with a focus on CVD, which should become mandatory and be based on the existing guidelines of professional societies.

Keywords: LDL cholesterol; arterial hypertension; blood pressure; cardio-reno-metabolic health; cardiovascular disease; chronic kidney disease; chronic non-communicable diseases; hypercholesterolemia; primary prevention; secondary prevention; stroke.

Figure 1

The estimated number of age-standardized deaths from cardiovascular diseases, all age groups, per 100,000 people. Izvor/Source: Eurostat.

Figure 2

Avoidable mortality (preventable and treatable) in Croatia and European Union (EU27) from 2011 to 2020; P + T = preventable and treatable; P = preventable; T = treatable; Izvor/Source: EUROSTAT.

Figure 3

Most effective approaches and measures for saving lives in the general population ((a) all-cause model; (b) cause-specific model). With permission from Am. J. Prev. Med. [24].