Deep Diving Into the Cardiovascular Health Paradox: A Journey Towards Personalized Prevention

Bamba Gaye, Nabila Bouatia Naji, Mario Sims, Yendelela Cuffee, Oluwabunmi Ogungbe, Erin D. Michos, Camille Lassale, Pierre Sabouret, Xavier Jouven

Research output: Contribution to journalReview articlepeer-review

Abstract

Objectives: The Life’s Simple 7 score (LS7) promotes cardiovascular health (CVH). Despite this, some with optimal LS7 develop cardiovascular disease (CVD), while others with poor CVH do not, termed the “CVH paradox.” This paper explores pathways explaining this paradox. Methods: We examined methodological aspects: 1) misclassification bias in self-reported lifestyle factors (smoking, physical activity, diet); 2) cumulative exposure to risk factors over a lifetime, impacting the CVH paradox. Punctual risk factor assessments are suboptimal for predicting outcomes. We proposed personalized prevention using “novel” elements to refine CVH assessment: 1) subclinical vascular disease markers, 2) metabolic biomarkers in blood and urine, 3) emerging risk factors, 4) polygenic risk scores (PRS), 5) epigenetics, and 6) the exposome. Results: Addressing the CVH paradox requires a multifaceted approach, reducing misclassification bias, considering cumulative risk exposure, and incorporating novel personalized prevention elements. Conclusion: A holistic, individualized approach to CVH assessment and CVD prevention can better reduce cardiovascular outcomes and improve population health. Collaboration among researchers, healthcare providers, policymakers, and communities is essential for effective implementation and realization of these strategies.

Original languageEnglish (US)
Article number1606879
JournalPublic Health Reviews
Volume45
DOIs
StatePublished - 2024

Keywords

  • cardiovascular health
  • CVH paradox
  • emerging risk factors
  • personalized approach
  • precision prevention

ASJC Scopus subject areas

  • Community and Home Care
  • Public Health, Environmental and Occupational Health

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