Public health articles within Nature Reviews Cardiology

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  • Review Article |

    In this Review, Bosworth and colleagues describe the causes of medication non-adherence, discuss interventions that have been clinically shown to improve adherence and identify areas for future research.

    • Adam J. Nelson
    • , Neha J. Pagidipati
    •  & Hayden B. Bosworth

  • 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 |

    A legally mandated preparticipation screening programme for all young people in Italy engaging in competitive sports has resulted in a very low rate of sports-related cardiac arrest and sudden cardiac death.

    • Gregory B. Lim

  • News & Views |

    Cardiopulmonary resuscitation (CPR) provided by a bystander has saved the lives of many patients with out-of-hospital cardiac arrest. Several factors have been hypothesized to contribute to the low rates of bystander CPR, including the race and/or ethnicity of the recipient and the location of the out-of-hospital cardiac arrest.

    • Marcus Eng Hock Ong
    •  & Fahad Javaid Siddiqui

  • Clinical Outlook |

    Screening for atrial fibrillation in high-risk populations could contribute to the prevention of cardioembolic stroke. Randomized trials of atrial fibrillation screening are directionally favourable but underpowered for stroke risk assessment; nevertheless, meta-analysis results are encouraging. Consumer-facing wearable devices can detect unknown atrial fibrillation at scale, although they are mostly used by individuals at low risk of stroke.

    • Ben Freedman
    •  & Renate B. Schnabel

  • Review Article |

    In this Review, the authors summarize the evidence on the different effects of sex and gender on the pathogenesis, clinical manifestations and treatment responses of patients with ischaemic heart disease or heart failure. In addition, they highlight unexplored areas of sex-related and gender-related factors in cardiovascular disease such as in individuals with gender dysphoria.

    • Vera Regitz-Zagrosek
    •  & Catherine Gebhard

  • World View |

    As a Brazilian female cardiologist who has held leadership positions since my 40s, I understand the difficulties that women face in trying to achieve recognition and senior positions. I believe the awareness and joint efforts of both women and men can help build a more equitable future.

    • Andréa A. Brandão

  • 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 mortality and birth prevalence of congenital heart disease (CHD) have shifted in the past 50 years owing to advances in diagnosis and treatment. In this Review, Marelli and colleagues discuss the effect of this shift in CHD epidemiology on outcomes and disease burden in adult patients and describe new initiatives and technology that can improve the delivery of health care.

    • Aihua Liu
    • , Gerhard-Paul Diller
    •  & Ariane Marelli

  • Clinical Outlook |

    Meta-analyses and cardiovascular outcome trials are laying the foundation for seasonal influenza vaccines to be a mainstay in the prevention of cardiovascular disease, rivalling established measures such as statin therapy. In this Clinical Outlook, we highlight current and future approaches for the use of influenza vaccination to reduce the risk of atherosclerotic cardiovascular disease and heart failure.

    • Bahar Behrouzi
    •  & Jacob A. Udell

  • Comment |

    Clinical practice guidelines provide evidence-informed recommendations to improve the delivery of high-quality health care. Despite their ubiquity, the translation of clinical guidelines into routine clinical practice remains suboptimal. We propose the use of implementation science methods in the development of clinical practice guidelines to improve uptake.

    • Mitchell N. Sarkies
    • , Laney K. Jones
    •  & Gerald F. Watts

  • Research Highlight |

    The STROKESTOP trial and The LOOP study used different approaches to screen for atrial fibrillation, with the aim of initiating oral anticoagulation to prevent stroke and death.

    • Gregory B. Lim

  • Review Article |

    In this Review, Townsend et al. describe the epidemiology of cardiovascular disease across the WHO European Region and call for improved surveillance and monitoring to inform the development and implementation of evidence-based preventive and treatment approaches.

    • Nick Townsend
    • , Denis Kazakiewicz
    •  & Panos Vardas

  • Review Article |

    Valvular heart disease (VHD) is a major contributor to loss of physical function, quality of life and longevity. In this Review, Prendergast and colleagues discuss the global burden of VHD, geographical variation in the presentation and clinical management, and temporal trends in disease burden.

    • Sean Coffey
    • , Ross Roberts-Thomson
    •  & Bernard D. Prendergast

  • Research Highlight |

    Patients with cardiovascular disease who live with socioeconomic disadvantage face barriers to healthy living. A new study assessing social disadvantage burden reveals that this patient population has poor adherence to COVID-19 risk-mitigation recommendations.

    • Ciarán Martin Fitzpatrick

  • Comment |

    The homogeneity of cardiovascular clinical trial populations limits the generalizability of results and compounds health inequities faced by women, older adults and people of colour. This Comment highlights the importance of diversity in clinical trial populations and describes multifaceted interventions that might help to close the diversity gap in trial enrolment.

    • Erin D. Michos
    •  & Harriette G. C. Van Spall

  • 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 available literature suggests that electronic cigarettes (e-cigarettes), although not without risk, might decrease cardiovascular risk in chronic smokers of tobacco cigarettes who switch to e-cigarettes. However, to safeguard our youth, e-cigarettes must be required to meet product standards, all flavourings must be banned and laws regulating e-cigarette sales must be strictly enforced.

    • Holly R. Middlekauff

  • 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

  • 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 |

    Inherited arrhythmias are a major cause of sudden cardiac death, particularly among young individuals. In this Review, Offerhaus and colleagues provide an overview of the epidemiology of inherited ventricular arrhythmias, focusing on natural history, prevalence and patient demographics.

    • Joost A. Offerhaus
    • , Connie R. Bezzina
    •  & Arthur A. M. Wilde

  • Comment |

    Africa is witnessing an epidemic of cardiovascular disease (CVD), with staggering morbidity and mortality. The spectrum of CVD includes hypertension, rheumatic heart disease, cardiomyopathy, atherosclerotic disease, congenital heart disease and tuberculous pericarditis. Opportunities exist to alter the trajectory of CVD epidemiology but require committed policy makers, functional health systems and an engaged citizenry.

    • Liesl Zühlke
    • , Karen Sliwa
    •  & Ntobeko A. B. Ntusi

  • Comment |

    Africa faces many health challenges, many of which are unique to the continent. Although rarely considered an important contributor to premature death in high-income countries, cardiopulmonary disease (CPD) is, for a number of reasons, a common condition affecting Africans at a young age. In addition to recognizing CPD as an important condition, we outline a pragmatic screening protocol for identifying CPD in the African context.

    • Simon Stewart
    • , Wael Al-Delaimy
    •  & Ana Mocumbi

  • Research Highlight |

    A novel, community-based model of care led by non-physician health workers significantly reduced blood pressure levels and risk of cardiovascular disease.

    • Karina Huynh

  • News & Views |

    The global burden of cardiovascular disease morbidity and mortality demands increased awareness of effective prevention strategies by patients, communities and health-care providers. The new 2019 ACC/AHA guidelines provide evidence-based, preventive recommendations for patients without known cardiovascular disease, focusing on risk estimation, a healthy lifestyle and selective indications for pharmacotherapy.

    • Rhanderson Cardoso
    •  & Khurram Nasir

  • Research Highlight |

    High-sensitivity troponin I levels are positively and strongly linked with incident coronary heart disease, heart failure hospitalization and all-cause mortality in individuals without known cardiovascular disease.

    • Karina Huynh

  • Perspective |

    The Framingham Heart Study (FHS) has been collecting epidemiological data on cardiovascular risk factors and disease for >70 years. In this Timeline Perspectives article, the authors summarize the major achievements of the FHS, highlight some of the seminal publications and discuss how epidemiological research has changed and continues to evolve.

    • Charlotte Andersson
    • , Andrew D. Johnson
    •  & Ramachandran S. Vasan

  • Year in Review |

    More than 150 years after acetylsalicylic acid was synthesized by French chemist Charles Frédéric Gerhardt, aspirin is still one of the most prescribed medications worldwide. In 2018, several trials have suggested that the role of aspirin in the contemporary era might be less pre-eminent than in previous decades.

    • Gilles Montalescot

  • Review Article |

    Cardiovascular disease (CVD) is the leading cause of death in China. In this Review, Zhao and colleagues summarize eight important features of the evolving epidemiology of CVD in China and discuss how this information can help to develop effective and timely strategies to prevent and treat CVD.

    • Dong Zhao
    • , Jing Liu
    •  & Mengge Zhou

  • Review Article |

    Reduction in salt consumption has long been recommended to lower blood pressure (BP) and the risk of cardiovascular disease (CVD). A linear relationship between salt intake and CVD risk has recently been challenged in some cohort studies; however, methodological issues exist with these studies. In this Review, He and MacGregor discuss the relationship between salt intake, BP, and CVD risk, and describe the benefits and challenges of reducing the population intake of salt.

    • Feng J. He
    •  & Graham A. MacGregor

  • Comment |

    The recent publication ofThe LancetCommission on pollution and health is a watershed moment for one of the greatest challenges to cardiovascular health. In this Comment article, we discuss the global burden of air pollution on cardiovascular health.

    • Michael B. Hadley
    • , Rajesh Vedanthan
    •  & Valentin Fuster

  • Review Article |

    In this Review, Kivimäki and Steptoe assess the current evidence on the association between stress and cardiovascular disease, covering the multiple roles of stress in the development and triggering of disease and as a determinant of prognosis and outcome. In addition, they discuss the clinical and public health importance of major stressors and the implications for prevention and treatment of cardiovascular disease.

    • Mika Kivimäki
    •  & Andrew Steptoe

  • News & Views |

    Cardiovascular disease is the world's leading cause of death, with a disproportionate burden in low-income and middle-income countries. The Resolve initiative — eliminating artificial trans fats, reducing dietary sodium, and improving treatment of elevated blood pressure — is a substantial step in the right direction, but more combined efforts will be required.

    • Rajesh Vedanthan
    •  & Valentin Fuster

  • Review Article |

    In the past 2 decades, an increasing prevalence of risk factors for cardiovascular disease, such as obesity, physical inactivity, and diabetes mellitus, has been observed among young adults (aged 18–45 years) living in developed countries. In their Review, Andersson and Vasan discuss the evolving risk factor burden and available epidemiological data on cardiovascular disease in young adults.

    • Charlotte Andersson
    •  & Ramachandran S. Vasan

  • Review Article |

    Cardiovascular mortality among the almost 600 million people living in the Eastern Mediterranean region (EMR) has been proposed to increase more dramatically in the next decade than in any other region except Africa. Turk-Adawi and colleagues summarize the available data on cardiovascular disease burden, risk factors, and treatment modalities for the EMR population.

    • Karam Turk-Adawi
    • , Nizal Sarrafzadegan
    •  & Sherry L. Grace

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