title: Evidence-based and heuristic approaches for customization of care in cardiometabolic syndrome after spinal cord injury.
abstract: Component and coalesced health risks of the cardiometabolic syndrome (CMS) are commonly reported in persons with spinal cord injuries (SCIs). These CMS hazards are also co-morbid with physical deconditioning and elevated pro-atherogenic inflammatory cytokines, both of which are common  after SCI and worsen the prognosis for all-cause cardiovascular disease. This article describes a systematic procedure for individualized CMS risk assessment after SCI, and emphasizes evidence-based and intuition-centered countermeasures to disease. A unified approach will propose therapeutic  lifestyle intervention as a routine plan for aggressive primary prevention in this risk-susceptible population. Customization of dietary and exercise plans then follow, identifying shortfalls in diet and activity patterns, and ways in which these healthy lifestyles can be more substantially  embraced by both stakeholders with SCI and their health care providers. In cases where lifestyle intervention utilizing diet and exercise is unsuccessful in countering risks, available pharmacotherapies and a preferred therapeutic agent are proposed according to authoritative standards. The  over-arching purpose of the monograph is to create an operational framework in which existing evidence-based approaches or heuristic modeling becomes best practice. In this way persons with SCI can lead more active and healthy lives.
authors.affiliation: Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. mnash@med.miami.edu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Nash
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Cowan
authors.forename: Jochen
authors.initials: J
authors.lastname: Kressler
mesh_terms: D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000453:epidemiology*; D019317:Evidence-Based Medicine / Q000639:trends*; D005081:Exercise Therapy / Q000639:trends*; D006801:Humans; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000628:therapy*