Disease prevention articles within Nature Reviews Cardiology

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  • Comment |

    Racial and ethnic disparities in cardiovascular health in the USA result in a persistent mortality gap between white and Black individuals, increase health-care costs and compromise an egalitarian society. Solutions to racial inequities require risk factor control and the implementation of evidence-based medicine and anti-racism policies. Overcoming these disparities is not only a practical necessity, but also a moral imperative.

    • Keith C. Ferdinand

  • Review Article |

    The menopausal transition period, which begins with irregular menstrual cycles and ends with the final menstrual period, is associated with an increase in cardiovascular risk. In this Review, Mehta and Manson describe the metabolic and cardiovascular changes that occur during the menopausal transition period and summarize the evidence on the use of targeted interventions to slow the progression of atherosclerosis.

    • Jaya M. Mehta
    •  & JoAnn E. Manson

  • Review Article |

    In this Review, Swirski and co-workers discuss how lifestyle factors modulate haematopoiesis and leukocyte migration in the context of cardiovascular homeostasis and disease, with particular focus on the role of the nervous system as the key executor connecting environmental influences to leukocyte behaviour.

    • Henrike Janssen
    • , Laura L. Koekkoek
    •  & Filip K. Swirski

  • Comment |

    Cardiovascular health is essential to achieving the United Nations Sustainable Development Goals (SDGs), particularly SDG3.4. Barriers include inequalities and a lack of political will and prioritization. A comprehensive approach is needed to reduce the global burden of cardiovascular disease and to achieve SDG3.4. The World Heart Federation addresses the determinants of cardiovascular disease and mobilizes the global community through roadmaps, roundtables and advocacy.

    • Daniel J. Piñeiro
    • , Elisa Codato
    •  & Jagat Narula

  • Review Article |

    In this Review, Gaillard and Jaddoe describe how maternal cardiovascular disorders, occurring before and during pregnancy, can influence cardiovascular health in the offspring from embryonic life until adulthood. Furthermore, the authors highlight critical periods for cardiovascular adaptations, including preconception, early pregnancy and infancy, and how the events occurring during these periods can have an effect on future cardiovascular health.

    • Romy Gaillard
    •  & Vincent W. V. Jaddoe

  • Research Highlight |

    In the SECURE trial, a polypill containing aspirin, ramipril and atorvastatin taken within 6 months after myocardial infarction reduces the risk of major adverse cardiovascular events compared with usual care.

    • Karina Huynh

  • Research Highlight |

    An invitation to undergo comprehensive cardiovascular screening in men aged 65–74 years did not lower the incidence of death from any cause after 5 years in the DANCAVAS trial, but data suggest benefits in some outcomes and in reducing mortality in men aged < 70 years.

    • Irene Fernández-Ruiz

  • Review Article |

    The evolution of stent design has reduced the incidence of stent thrombosis, meaning that the duration of dual antiplatelet therapy after percutaneous coronary intervention (PCI) might be shortened. In this Review, the authors describe the current evidence base and ongoing clinical trials into the use of P2Y12 inhibitor monotherapy after PCI.

    • Davide Capodanno
    • , Usman Baber
    •  & Dominick J. Angiolillo

  • Review Article |

    The most commonly available blood pressure (BP) monitoring devices are useful for capturing a snapshot BP value, but most have limited utility in measuring BP variability. In this Review, Schutte and colleagues outline the advantages and disadvantages of conventional and novel techniques to measure average BP levels and BP variability.

    • Aletta E. Schutte
    • , Anastasios Kollias
    •  & George S. Stergiou

  • News & Views |

    Cardiovascular disease is both a risk factor and potential outcome of the direct, indirect and long-term effects of COVID-19. A recent analysis in >150,000 survivors of COVID-19 demonstrates an increased 1-year risk of numerous cardiovascular diseases. Preventing and managing this new disease burden presents challenges to health systems and requires a learning health system approach.

    • Mohamed O. Mohamed
    •  & Amitava Banerjee

  • Review Article |

    In this Review, Raitakari and colleagues discuss the importance of initiating the prevention of atherosclerosis in early life and summarize the major paediatric programmes for the prevention of atherosclerotic cardiovascular disease.

    • Olli Raitakari
    • , Katja Pahkala
    •  & Costan G. Magnussen

  • Research Highlight |

    According to data from the GOAL trial, when latent rheumatic heart disease (RHD) is detected by echocardiographic screening, secondary prophylaxis with antibiotics is effective in preventing progression of the disease.

    • Gregory B. Lim

  • Clinical Outlook |

    Human genetic studies combined with biotechnological advances have guided and accelerated the development of PCSK9-targeting therapies. In this Clinical Outlook, we highlight present and future approaches for PCSK9 inhibition to reduce LDL-cholesterol levels and the risk of atherosclerotic cardiovascular disease.

    • Mahmoud Al Rifai
    •  & Christie M. Ballantyne

  • Research Highlight |

    Two new studies show that pharmacological blood pressure (BP) reduction is effective in older individuals and that a more intensive treatment with a lower BP threshold reduces the incidence of cardiovascular events in older patients with hypertension.

    • Irene Fernández-Ruiz

  • Research Highlight |

    In the QUARTET trial, initial treatment with a single pill containing quarter doses of four antihypertensive drugs achieved and maintained a greater blood-pressure-lowering effect than initial monotherapy with full-dose irbesartan.

    • Gregory B. Lim

  • News & Views |

    Mounting evidence from the SPRINT trial and the Blood Pressure Lowering Treatment Trialists points towards the use of absolute cardiovascular risk assessment to guide blood-pressure management. But who will fall between the cracks? We need to be pragmatic in keeping blood-pressure targets, if only to serve the >1 billion people at risk of cardiovascular disease living in low-resource settings.

    • Aletta E. Schutte

  • Review Article |

    Epidemiological studies indicate a genetic component to the risk of sudden cardiac death (SCD). In this Review, Behr and colleagues evaluate monogenic and polygenic contributions to the risk of SCD in the young and SCD associated with drug therapy and analyse the potential clinical role of genomic testing in the prevention of SCD in the general population.

    • Chiara Scrocco
    • , Connie R. Bezzina
    •  & Elijah R. Behr

  • Research Highlight |

    A new study demonstrates a deficiency of NAD+ in patients with heart failure with preserved ejection fraction and indicates that restoration of NAD+ levels with nicotinamide supplementation might have therapeutic value to treat diastolic dysfunction in these patients.

    • Andrew Robson

  • Research Highlight |

    In the TIPS-3 trial, a single polypill comprising blood-pressure-lowering and cholesterol-lowering drugs, together with a daily dose of aspirin, reduced cardiovascular events in people at risk of cardiovascular disease.

    • Andrew Robson

  • Review Article |

    In this Review, Lucia and colleagues discuss the epidemiological evidence on the benefits of major lifestyle interventions in the prevention and adjuvant treatment of hypertension, including regular physical exercise, body weight management, healthy diet, adequate sleep patterns, circadian entrainment and stress management. The authors also describe the main physiological mechanisms underlying these benefits.

    • Pedro L. Valenzuela
    • , Pedro Carrera-Bastos
    •  & Alejandro Lucia

  • Research Highlight |

    According to findings from the POPular TAVI trial, in patients without an indication for oral anticoagulation, the use of aspirin alone compared with aspirin plus clopidogrel after transcatheter aortic valve implantation significantly reduced bleeding rates and did not increase thromboembolic events.

    • Andrew Robson

  • Review Article |

    Patients with coronary artery disease (CAD) are at high risk of perioperative cardiovascular complications related to non-cardiac surgery. In this Review, Mehran and colleagues summarize trial data and guideline recommendations on preoperative risk stratification and periprocedural management of patients with CAD undergoing non-cardiac surgery.

    • Davide Cao
    • , Rishi Chandiramani
    •  & Roxana Mehran

  • Comment |

    Yoga has been associated with improvements in numerous cardiovascular risk factors and has the potential to address the unmet needs of current cardiovascular prevention strategies. Large and well-designed clinical trials are needed to assess the benefits of yoga across the spectrum of cardiovascular diseases and to provide the evidence required for its widespread implementation.

    • Dorairaj Prabhakaran
    •  & Ambalam M. Chandrasekaran

  • Comment |

    The notion that atherosclerosis can be prevented or mitigated by vaccination is now moving towards clinical trials. This strategy is based on the existence of autoimmunity to LDL, the cholesterol-carrying particles that accumulate in arteries. In this Comment, we discuss the underlying concepts, research basis and challenges for the development of a vaccine against atherosclerosis.

    • Göran K. Hansson
    •  & Jan Nilsson

  • Research Highlight |

    The safety and durability of the LDL-cholesterol-lowering effects of inclisiran, a small interfering RNA that inhibits the synthesis of PCSK9 in the liver, have now been confirmed in three phase III clinical trials published in the New England Journal of Medicine.

    • Irene Fernández-Ruiz

  • News & Views |

    Salt substitutes hold great potential for the control of blood pressure and prevention of chronic disease, but the evidence base remains inadequate. Data from a community-based trial in Peru add to this evidence base and support the conduct of large-scale trials to drive the global uptake of salt substitution.

    • Bruce Neal
    •  & Matti Marklund

  • Review Article |

    Moderate exercise improves cardiovascular health and is associated with physiological cardiac adaptations; by contrast, the hearts of endurance athletes can undergo maladaptations, including myocardial fibrosis and arrhythmias. In this Review, Parry-Williams and Sharma discuss whether excessive endurance exercise might damage both diseased and otherwise normal hearts.

    • Gemma Parry-Williams
    •  & Sanjay Sharma

  • Comment |

    Awareness of the effect of the neighbourhood built environment on cardiovascular diseases is growing. In this Comment, we identify major conceptual, methodological and policy-relevant issues in research related to the built environment and describe potential future directions to improve the scientific rigour of research in this field.

    • Mohammad Javad Koohsari
    • , Gavin R. McCormack
    •  & Koichiro Oka

  • Review Article |

    Many patients with cardiovascular disease have a residual risk of ischaemic events despite receiving antiplatelet therapy. In this Review, Angiolillo and colleagues discuss the pharmacological rationale and clinical development of dual-pathway inhibition strategies for the prevention of atherothrombotic events in patients with cardiovascular disease.

    • Davide Capodanno
    • , Deepak L. Bhatt
    •  & Dominick J. Angiolillo

  • Comment |

    Our understanding of the causes and consequences of pulmonary hypertension is limited. Consequently, its most distinctive forms with the worst prognosis have been the focus for diagnosis and treatment. We highlight the emerging challenge of reframing the prevalence and prognostic implications of pulmonary hypertension, focusing on the optimal therapeutic window to address the high mortality linked to this condition.

    • Simon Stewart
    • , Geoffrey A. Strange
    •  & David Playford

  • Research Highlight |

    Levels of non-HDL cholesterol in the blood are strongly linked with long-term risk of cardiovascular disease, according to a new risk evaluation study that followed-up almost 400,000 individuals without cardiovascular disease at baseline for a median of 13.5 years.

    • Karina Huynh

  • Research Highlight |

    Results of the GALILEO trial presented at the AHA Scientific Sessions 2019 indicate that a strategy with rivaroxaban 10 mg daily is associated with a higher risk of death or thromboembolic events and a higher risk of bleeding than an antiplatelet-based strategy.

    • Irene Fernández-Ruiz

  • Research Highlight |

    A new study shows that regular physical activity exerts cardiovascular beneficial effects by reducing the proliferation of haematopoietic stem and progenitor cells via modulation of their niche, leading to a reduction in the systemic supply of inflammatory leukocytes.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Statin therapy initiated during childhood in patients with familial hypercholesterolaemia (FH) slows the rate of carotid intima–media thickening and reduces the risk of cardiovascular events and death.

    • Gregory B. Lim

  • Research Highlight |

    New findings from the Hygia Chronotherapy trial suggest that taking antihypertensive medications at bedtime is associated with better blood-pressure control and a 45% reduction in the risk of cardiovascular disease compared with taking the medication in the morning upon waking up.

    • Irene Fernández-Ruiz

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