TY - JOUR
T1 - Deep Diving Into the Cardiovascular Health Paradox
T2 - A Journey Towards Personalized Prevention
AU - Gaye, Bamba
AU - Naji, Nabila Bouatia
AU - Sims, Mario
AU - Cuffee, Yendelela
AU - Ogungbe, Oluwabunmi
AU - Michos, Erin D.
AU - Lassale, Camille
AU - Sabouret, Pierre
AU - Jouven, Xavier
N1 - Publisher Copyright:
Copyright © 2024 Gaye, Naji, Sims, Cuffee, Ogungbe, Michos, Lassale, Sabouret and Jouven.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - cardiovascular health
KW - CVH paradox
KW - emerging risk factors
KW - personalized approach
KW - precision prevention
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U2 - 10.3389/phrs.2024.1606879
DO - 10.3389/phrs.2024.1606879
M3 - Review article
C2 - 39145154
AN - SCOPUS:85201118951
SN - 0301-0422
VL - 45
JO - Public Health Reviews
JF - Public Health Reviews
M1 - 1606879
ER -