Can we improve primary prevention of ischemic heart disease? Which way?

Authors: Ján Murín;  Miroslav Pernický;  Martin Wawruch
Authors‘ workplace: I. interná klinika a Ústav farmakológie a klinickej farmakológie LF UK a UN Bratislava, Nemocnica Staré Mesto
Published in: AtheroRev 2016; 1(3): 116-119
Category: Reviews


Cardiovascular diseases are today in our country and also in the world the most frequent causes of mortality. Without some improvement also in a primary cardiovascular prevention we will not be successful in fighting these diseases. This is but not an easy way to walk. We should improve education of people about cardiovascular risk factors and how to fight them, and of education about our dietary habits. There is also some discussion about a hypocholesterolemic (by drugs) treatment of “healthy” middle aged people, when atherosclerosis is not yet well progressed. This knowledge comes from big and long-term clinical studies. Recently started ECAD (Eliminate Coronary Artery Disease) study, with a follow-up for a decade, can confirm this treatment modality in primary prevention.

Key words:
cardiovascular diseases – primary prevention – risk factors – dietary habits – reduction of serum cholesterol level


1. Domanski M, Lloyd-Jones D, Fuster V et al. Can we dramatically reduce the incidence of coronary heart disease? Nat Rev Cardiol 2011; 8(12): 721–725. Dostupné z DOI: <>.

2. Fuster V, Kelly BB, Vedanthan R. Promoting global cardiovascular health: moving forward. Circulation 2011; 123(15): 1671–1678. Dostupné z DOI: <>.

3. Chen Z, Peto R, Collins R et al. Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. BMJ 1991; 303(6797): 276–282.

4. Domanski MJ, Fuster V, Mitoma F-D et al. Next steps in primary prevention of coronary heart disese. J Amer Coll Cardiol 2015; 66(16): 1828–1836. Dostupné z DOI: <>.

5. Piťha J. Boj s aterosklerózou: větší síla nebo lepší načasování? AtheroRev 2016; 1(1): 14–18.

6. Vrablik M, Schwarzová L, Freiberger T et al. Familiární hypercholesterolemie: klinické nálezy, molekulární genetika a diferenciální diagnostika. AtheroRev 2016; 1(1): 19–27.

7. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012; 33(13): 1635–1701. Dostupné z DOI: <>. Erratum in Eur Heart J 2012; 33(17): 2126.

8. Mensink RP, Zock PL, Kester AD et al. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003; 77(5): 1146–1155.

9. Wang DD, Leung CW, Li Y et al. Trends in dietary quality among adults in the United States, 1999 through 2010. JAMA Intern Med 2014; 174(10): 1587–1595. Dostupné z DOI: <>.

10. Estruch R, Ros E, Salas-Salvadó J et al. [PREDIMED Study Investigators]. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013; 368: 1279–1290. Dostupné z DOI: <>. Erratum in N Engl J Med 2014; 370(9): 886.

11. Chowdhury R, Warnakula S, Kunutsor S et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med 2014; 160(6): 398–406. Dostupné z DOI: <–1788>. Erratum in Ann Intern Med 2014; 160(9): 658.

12. Jakobsen MU, O’Reilly EJ, Heitmann BL et al. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 2009; 89(5): 1425–1432. Dostupné z DOI: <>.

13. Y Li, A Hruby, AM Bernstein et al. Saturated Fats compared with Unsaturated Fats as Source of Carbohydrates in Relation to Risk of Coronary Heart Disease. J Am Coll Cardiol 2015; 66(14): 1538–1548. Dostupné z DOI: <>.

14. Estruch R, Ros E, Salas-Salvadó J et al. [PREDIMED Study Investigators]. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013; 368(14): 1279–1290. Dostupné z DOI: <>.

15. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat:a systematic review and meta-analysis of randomized controlled trials. PLoS Med 2010; 7(3): e1000252. Dostupné z DOI: <>.

16. U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2010. 7th ed. Washington, DC: U.S. Government Printing Office: 2010. Dostupné z WWW: <>.

17. Cohen JC, Boerwinkle E, Mosley TH Jr et al. Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N Engl J Med 2006; 354(12): 1264–1272.

18. Sever PS, Dahloef B, Poulter NR et al. [ASCOT Investigators]. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA): a multicenter randomized controlled trial. Lancet 2003; 361(9364): 1149–1158.

19. Wissler RW, Strong JP, PDAY Research Group. Risk factors and progression of atherosclerosis in youth. Am J Pathol 1998; 153(4): 1023–1033.

20. Ridker PM, Danielson E, Fonseca FA et al. [JUPITER Study Group]. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 2008; 359(21): 2195–2207. Dostupné z DOI: <>.

21. Ford I, Murray H, Packard CJ et al. [West of Scotland Coronary Prevention Study Group]. Long-term follow-up of the West of Scotland Coronary Prevention Study. N Engl J Med 2007;357(15): 1477–1486.

Angiology Diabetology Internal medicine Cardiology General practitioner for adults
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account