Cardiovascular Health Risk Assessment and Primary Prevention of Atherosclerotic Cardiovascular Disease

This review of cardiovascular health risk assessment and therapeutic approach to prevention of atherosclerotic cardiovascular disease (ASCVD) is intended to provide an experienced perspective for health care professionals, and not to replace judgement.Reducing risk factors for ASCVD and related events by prevention affects the most important causes of death and disability in the modern world.Yet ideal cardiovascular health, which is also associated with less cancer, is rare despite the collective efforts of providers, non-profit organizations, governments, employers, the media, and insurance carriers.In fact, there is a worldwide increase in modifiable risk factors.While optimizing lifestyle is the essential focus for primordial and primary prevention, available generic drugs for the evidence-based prevention treatments are cost effective.And the recent availability of reasonably well calibrated risk estimators (number actual versus number predicted CV events) and recent clinical trials that better inform promotes a more cost/benefit selection process.Herein we review the literature to support the evidence-based rationale and approach to primary prevention of ASCVD from youth to the elderly, discuss the use of risk-estimators and utility of risk enhancers and coronary calcium scores, review guidelines for statin use, aspirin, metabolic syndrome/diabetes, hypertension, and summarize importance of lifestyle.It's essential a team-based care approach be the strategy to prevent ASCVD that can/should include the primary care physician, nurses, physician extenders, wellness coaches, nutrition and exercise specialists, community health and wellness centers, and referral to prevention specialists as indicated.