Blood pressure: a second target for preventing CVD

Hypertension or elevated blood pressure (BP), namely Systolic BP ≥ 140 and/or Diastolic BP ≥ 90 mmHg has been identified as one of the major risk factors for CHD, stroke and heart failure10.

High sodium (salt) intake, low potassium intake, high alcohol consumption, smoking and physical inactivity, as well as body weight gain may increase BP in susceptible subjects11.

Targeted lifestyle modifications are the cornerstone for the prevention of hypertension. Healthy diet and lifestyle changes are recommended in all patients with suboptimal and elevated BP and should always be advised for patients receiving BP-lowering drugs, as these may reduce the dose of BP-lowering drugs needed to achieve BP control3. The dietary intervention specific to hypertension is salt restriction. At best, advice should be given to avoid added salt and high-salt food next to advice to eat more fruits and vegetables and to reduce intake of saturated fat and cholesterol3.

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Dietary modifications should form the basis for CVD prevention

Other modifiable CVD risk factors: Obesity

Dyslipidemia, diabetes, and CVD, or any combination of these, are the most common metabolic complications of obesity. Risk of CHD, ischemic stroke and type 2 diabetes increases steadily with an increasing body mass index (BMI)12.

Weight reduction, as well as prevention of further body weight gain is indispensable to prevent or delay the major metabolic complications of obesity and to reduce CVD risk3.

Other modifiable CVD risk factors: Diabetes

CVD is the leading cause of morbidity and mortality in people with diabetes mellitus3. Patients with diabetes, especially type 2 diabetes, often have an unhealthy blood lipid profile, including high LDL-cholesterol, low HDL-cholesterol, and high TG. Together with hyperglycemia, dyslipidemia in diabetic patients may facilitate the development of CHD and other complications of atherosclerosis3.

Diet and lifestyle intervention remains a key component for CVD prevention also in patients with diabetes. Weight reduction in overweight or obese subjects, increasing physical activity and adopting a healthy, well-balanced diet are fundamental considerations to improve both glycemic control and the blood lipid profile, thus reducing CVD risk.