When in Rome, don’t do as the Romans do

Excerpt

In 2010, the American Heart Association (AHA) established, and made available to the public, an aggregation of 7 targets for health behaviours and factors, “The Simple 7”, to enhance awareness of and promote heart-healthy behaviours to reach the goal of 20% reduction in cardiovascular mortality (Table 1) [1]. All the seven factors are classified in three categories: ideal, intermediate, and poor. To achieve the target of “Ideal Cardiovascular Health,” a single subject has to respect the ideal category for all the seven factors. The definition emphasizes the importance of modifiable risk factors for which patients can take ownership and control, because the basic principles of cardiovascular disease prevention (no smoking, regular physical activity, healthy diet, and keeping hypertension, dyslipidaemia, and diabetes under control) impact the prevalence of cardiovascular risk factors more than any other strategy. At least 50% of the reduction in cardiovascular events observed during the last decades is indeed attributable to preventive efforts, specifically control of blood pressure, treatment of dyslipidaemias, and a reduction in smoking [2]. Nevertheless, epidemiological studies, and large surveys are revealing that we are still far away from desired targets, because the penetration of poor health in the population is alarming. In the US, only 1 of the nearly 2000 participants to the Heart SCORE study (0.1%) embraced all the “Simple 7” factors, where only 1.4 and 2% of the subjects presented all 4 health factors (high blood pressure, high blood glucose, high blood cholesterol, smoking) and all 4 health behaviours (low physical activity, poor diet, high body weight, and smoking), respectively [3]. …