The Role of Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease
- 949 Downloads
Whereas primary prevention seeks to forestall development of disease in individuals with elevated risk, primordial prevention seeks to preempt the development of risk factors. Health behaviors—characterized as “lifestyle” factors—are key interventional targets in primordial prevention of cardiovascular disease. Appropriate dietary intake, including limiting salt and saturated fat consumption, can reduce the risk of developing hypertension and dyslipidemias. Regular physical activity is associated with lower blood pressure and healthier lipid profiles. Diet and exercise are critical to maintaining weight conducive to cardiovascular health. Behavioral factors such as stress management, sleep duration, portion control, and meal timing may play a role in weight management and offer additional routes of intervention. Any smoking elevates cardiovascular risk. Although lifestyle modification programs can be instrumental in reaching public health goals, maintaining cardiovascular health should not be a matter solely of willpower. Ideally, structural and social forces should make healthy lifestyles the default option.
KeywordsPrimordial prevention Lifestyle Behavioral intervention Cardiovascular health
Compliance with Ethical Standards
Conflict of Interest
Steven A. Claas and Donna K. Arnett declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This review article does not contain any previously unpublished data arising from studies of human or animal subjects performed by either of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.•Mozaffarian D, Benjamin EJ, Go AS, et al.: Heart Disease and Stroke Statistics-2016 update: a report from the American Heart Association. Circulation. 2015. The latest of the AHA’s yearly and definitive assessments of the state of CV health and disease in the US.Google Scholar
- 4.National Heart LaBI. Report of the task force on research in epidemiology and prevention of cardiovascular diseases. Washington, DC: National Institutes of Health, Public Health Service, US Department of Health and Human Services; 1994.Google Scholar
- 5.American College of Cardiology: CardioSmart. https://www.cardiosmart.org. Accessed 13 Jan 2016.
- 6.American Heart Association: My Life Check—Life’s Simple 7. http://www.heart.org/HEARTORG/Conditions/My-Life-Check---Lifes-Simple-7_UCM_471453_Article.jsp-.Vpl1CzaxH8s. Accessed 15 Jan 2016.
- 14.Appel LJ, Baker DH, Bar-Or O, et al. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: Institute of Medicine; 2005.Google Scholar
- 15.Ekmekcioglu C, Elmadfa I, Meyer AL et al. The role of dietary potassium in hypertension and diabetes. J Physiol Biochem. 2015.Google Scholar
- 20.2015-2020 dietary guidelines for Americans. US Department of Health and Human Services and US Department of Agriculture. 2015.Google Scholar
- 35.Raben A, Moller BK, Flint A et al. Increased postprandial glycaemia, insulinemia, and lipidemia after 10 weeks’ sucrose-rich diet compared to an artificially sweetened diet: a randomised controlled trial. Food Nutr Res. 2011; 55.Google Scholar
- 36.American Heart Association: Added sugars add to your risk of dying from heart disease. American Heart Association. http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Added-Sugars-Add-to-Your-Risk-of-Dying-from-Heart-Disease_UCM_460319_Article.jsp. Accessed 15 Feb 2016.
- 38.American Heart Association: The American Heart Associations diet and lifestyle recommendations. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp. Accessed 12 Jan 2016.
- 40.••Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129:S76–99. This documents the AHA’s assessment of all lifestyle-based primordial and primary prevention interventions and the level of evidence associated with each. The 172-page full report is available online.CrossRefPubMedGoogle Scholar
- 46.Committee PAGA. Physical activity guidelines advisory committee report, 2008. Washington, DC: US Department of Health and Human Services; 2008.Google Scholar
- 60.My Life Check. American Heart Association. https://mlc.heart.org. Accessed 15 Jan 2016.
- 61.American Heart Association: Life’s Simple 7 for Kids. http://www.heart.org/HEARTORG/GettingHealthy/HealthierKids/LifesSimple7forKids/Lifes-Simple-7-for-Kids_UCM_466610_SubHomePage.jsp. Accessed 15 Jan 2016.
- 71.••Pearson TA, Palaniappan LP, Artinian NT, et al. American Heart Association Guide for improving cardiovascular health at the community level, 2013 update: a scientific statement for public health practitioners, healthcare providers, and health policy makers. Circulation. 2013;127:1730–53. This describes the AHA’s rationales and recommendations for community-based primordial and primary prevention measures.CrossRefPubMedGoogle Scholar