A global view on the prevention of cardiovascular disease

Sophia Antipolis, 15 April 2014. The United Nations and the World Health Organization pledged in 2011 to reduce premature mortality from non-communicable diseases - most notably cardiovascular diseases - by 25% by the year 2025. It's an ambitious target, reached with much controversy by UN members, and progress so far will be charted at this year's major congress on cardiovascular prevention, EuroPRevent 2014.

The theme of this year's congress is "global cardiovascular health", and chairman of the Congress Programme Committee, Professor Johan de Sutter from AZ Maria Middelares Hospital in Ghent, Belgium, insists that the known modifiable risk factors for cardiovascular and other non-communicable disease are no longer confined to the affluent countries of the West.

"There are more cardiovascular deaths in India and China than in all developed countries together," says De Sutter. "The lessons learned in the West need to be blended with those factors now responsible for the steady rise of metabolic and cardiovascular disease around the globe. The dynamics of these disease patterns demand that we join forces to enter a new era of fight against the burden of cardiovascular disease on an unprecedented scale."

One session of EuroPRevent 2014 will review targets for the prevention of non-communicable diseases and the WHO's action plan for 2013-2020. Hosted by the Global Forum on CVD Prevention in clinical practice (a common platform for multiple organisations facilitated by the EACPR, a registered branch of the ESC), a session on 9 May (11.00-12.30) will offer an update report from Shanthi Mendis of the WHO, assess those prevention strategies which work for the rich and the poor, and focus on obesity as an emerging global challenge, particularly in children.

EACPR will be taking part in an initiative of the city of Amsterdam during the congress to highlight the risks of childhood obesity in local schools. “Jump In” will promote healthy diets and exercise in over 80 primary schools, where fruit will be served.

One new study to be reported from the congress in an ESC press release will describe the shape of things to come, with a modeled forecast of obesity trends (and incidence rates in heart disease) up to the year 2030.

Data reported to the UN General Assembly in 2011 indicated that only 3% of all current healthcare spending is directed at prevention. The rest is consumed by treatment. While all non-communicable diseases are "treatable", rarely are they curable - although the majority of them are indisputably preventable.

EuroPRevent will also emphasise the "heart-lung interaction in preventive cardiology" in a featured scientific session. This important session, co-organised by the Dutch Heart Foundation and Belgian Working Group on Preventive Cardiology, will focus on the disastrous effects of smoking on the prevalence of all chronic diseases (9 May, 14.00-15.30). A comprehensive tobacco control strategy is being promoted by the WHO's Framework Convention on Tobacco Control. One of the speakers during this session, Dr Goran Boëthius, Chairman of the European Heart Network (EHN) Tobacco Expert Group, will describe smoking as "one of the most important modifiable risk factors in the development of cardiovascular disease", but one whose control must be applied at the population (ie, political) as well as individual level. Congress participants will have the opportunity to sign a statement initiated by the EHN for plain packaging on cigarettes.

Other scientific sessions will highlight emerging themes in sports medicine, hypertension and exercise, and provide new evidence in established themes. There will be consideration here of new CVD prevention guidelines in the USA, which appear to prioritise lowering cholesterol but without the precise targets apparent in European guidelines.

"This could have a huge impact on how we apply prevention guidelines," says De Sutter.

He also singles out the featured lecture given by Dr Greg Thomas on the Horus study, which analysed by CT scanning 137 mummified bodies of ancient history. Contrary to what one might expect in people who died so young, atherosclerosis was apparent in these subjects. The implication, says Thomas, is that the basic diets of ancient history were not necessarily protective against CVD - and that we as humans are all susceptible.