Heart 360 Website & the reduction of cardiovascular risk factors

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Cardiovascular disease (CVD) is the leading cause of death in most developed countries, with a prevalence that is rapidly increasing in developing countries as well. Many risk factors for cardiovascular disease are modifiable by specific preventive measures, therein offering an opportunity to reduce the burden of CVD worldwide. This provides the framework for the implementation of the Heart 360 tracking tool to assist people in maintaining a heart healthy lifestyle.

The presence of established risk factors is associated with coronary heart disease (CHD), and the achievement and maintenance of good health is being emphasized in programs from The American Heart Association that promote seven ideal cardiovascular health metrics that are tracked in the Heart360 tool which include: Not smoking, being physically active, having a normal blood pressure, having a normal blood glucose level, having a normal total cholesterol level, being normal weight and eating a healthy diet. What is significant is that the cardiovascular risk factor metrics that are considered in the Heart 360 tool are all modifiable by the patient. Of note, factors such as family history of early onset cardiovascular disease are important, but are not considered in the tool and overall risk reduction. This emphasizes that individual accountability is an important factor in a heart healthy lifestyle.

Cigarette smoking is an important and reversible risk factor for CHD. In 2015, approximately 15 percent of US adults age ≥18 year were smoking [3]. The incidence of a myocardial infarction (MI) is increased sixfold in women and threefold in men who smoke at least 20 cigarettes per day compared with subjects who never smoked [4,5]. Exercise of even moderate degree has a protective effect against coronary heart disease and all-cause mortality [6,7,8-10]. Exercise may have a variety of beneficial effects including an elevation in serum HDL-cholesterol, a reduction in blood pressure, less insulin resistance, and weight loss. Hypertension is a well established risk factor for adverse cardiovascular outcomes, including mortality from CHD and stroke [11,12]. The lifetime risk of developing CVD is significantly higher among patients with hypertension. In a cohort of over 1.25 million patients aged 30 years or older without baseline CVD, including 20 percent with baseline treated hypertension, patients with baseline hypertension had a 63.3 percent lifetime risk of developing CVD compared with a 46.1 percent risk for those with normal baseline blood pressure [13]

Insulin resistance, hyperinsulinemia, and elevated blood glucose are associated with atherosclerotic cardiovascular disease [17-24]. In the INTERHEART study, diabetes accounted for 10 percent of the population-attributable risk of a first myocardial infarction (MI) [23]
The prevalence of dyslipidemia is increased in patients with premature CHD, being as high as 75 to 85 percent compared with approximately 40 to 48 percent in age-matched controls without CHD [14,15]. In the INTERHEART study, dyslipidemia (defined as a raised apo B to apo A-1 ratio) accounted for 49 percent of ...