Elsevier

International Journal of Cardiology

Volume 180, 1 February 2015, Pages 114-119
International Journal of Cardiology

Review
Challenges in secondary prevention of cardiovascular diseases: A review of the current practice

https://doi.org/10.1016/j.ijcard.2014.11.107Get rights and content

Highlights

  • More investment in preventive measures and facilities, more information on prevention within the cardiologists’ community.

  • Cardiologists’ involvement in implementing health policies of secondary prevention at continental and each country levels.

  • Well designed pathways for the continuity of care.

  • Formally shared responsibilities for all professionals involved, including invasive and surgical colleagues.

  • Minimum standards in terms of duration and quality of services delivered, within certified centres.

Abstract

With the changing demography of populations and increasing prevalence of co-morbidity, frail patients and more complex cardiac conditions, the modern medicine is facing novel challenges leading to rapid innovation where evidence and experiences are lacking. This scenario is also evident in cardiovascular disease prevention, which continuously needs to accommodate its ever changing strategies, settings, and goals. The present paper summarises actual challenges of secondary prevention, and discusses how this intervention should not only be effective but also efficient. By this way the paper tries to bridge the gaps between research and real-world findings and thereby may find ways to improve standard care.

Section snippets

The gap between knowledge and clinical implication

Over the past decades, secondary prevention measures have greatly improved and data from over 50 randomized trials and meta-analyses data have demonstrated that such measures reduce cardiovascular risk and event rates, foster healthy behaviours, and promote active lifestyles [1]. The benefits of secondary prevention have been shown to be significant in the contemporary era of early invasive revascularization as they were in the thrombolytic era [2], and 24 European national cardiac societies

Ongoing challenges in secondary prevention

The European Association for Cardiovascular Prevention & Rehabilitation (EACPR) has tried to identify the problems which obstruct better provision of preventive care and to develop documents that help to links theory into practice. (Table 1)

An evolving cardiology scenario

In general, modern medicine needs to review strategies, settings, and goals since new challenges from changing population demography, increasing clinical complexity and the development of novel technological management are emerging in a context of economic constraints.

Conclusion

The challenges of secondary prevention of cardiovascular diseases require further actions, which may be summarised as

  • 1.

    More investment in preventive measures and facilities.

  • 2.

    Involvement of the cardiologists in implementing health policies favouring the development of secondary prevention, at the continental level and in each single country.

  • 3.

    Well designed pathways for the continuity of care

  • 4.

    Formally shared responsibilities for all professionals involved in the care of cardiac patients, including

Contributorship

The first author (MFP) as guarantor is the main responsible for the overall content.

All authors have contributed with important critical inputs and revision of the manuscript.

Funding

None.

Conflict of interest

None.

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