Update in cardiology: vascular risk and cardiac rehabilitation.
Cardiovascular disease develops in a slow and subclinical manner over decades, only to manifest suddenly and unexpectedly. The role of prevention is crucial, both before and after clinical appearance, and there is ample evidence of the effectiveness and usefulness of the early detection of at-risk individuals and lifestyle modifications or pharmacological approaches. However, these approaches require time, perseverance, and continuous development. The present article reviews the developments in 2013 in epidemiological aspects related to prevention, includes relevant contributions in areas such as diet, weight control methods (obesity is now considered a disease), and physical activity recommendations (with warnings about the risk of strenuous exercise), deals with habit-related psychosocial factors such as smoking, provides an update on emerging issues such as genetics, addresses the links between cardiovascular disease and other pathologies such as kidney disease, summarizes the contributions of new, updated guidelines (3 of which have recently been released on topics of considerable clinical importance: hypertension, diabetes mellitus, and chronic kidney disease), analyzes the pharmacological advances (largely mediocre except for promising lipid-related results), and finishes by outlining developments in the oft-neglected field of cardiac rehabilitation. This article provides a briefing on controversial issues, presents interesting and somewhat surprising developments, updates established knowledge with undoubted application in clinical practice, and sheds light on potential future contributions.
Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain. Electronic address: egalve@vhebron.net.
Enrique
E
Galve
Servicio de Cardiología, Policlínica Gipuzkoa, San Sebastián, Guipúzcoa, Spain.
Eduardo
E
Alegría
Departamento de Cardiología, Hospital Universitario de San Juan, Sant Joan d'Alacant, Alicante, Spain.
Alberto
A
Cordero
Servicio de Cardiología, Consorcio Hospital General de Valencia, Valencia, Spain.
Lorenzo
L
Fácila
Servicio de Cardiología, Hospital La Paz, Madrid, Spain.
Jaime
J
Fernández de Bobadilla
Grupo de Epidemiología y Genética Cardiovascular, IMIM (Institut Hospital del Mar d'Investigacións Mèdiques), Barcelona, Spain.
Carla
C
Lluís-Ganella
Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Pilar
P
Mazón
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid, Spain.
Carmen
C
de Pablo Zarzosa
Servicio de Cardiología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
José Ramón
JR
González-Juanatey
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D040242:Risk Reduction Behavior
Diabetes mellitus; Ejercicio físico; Factores de riesgo; Hipertensión arterial; Hypertension; Physical exercise; Puesta al día; Risk factors; Tabaco; Tobacco; Update