Médecine interne: libre accès
Libre accès

Abstrait

New Concepts in the Diagnosis and Non-Surgical Treatment of Cardiovascular Disease

Mark C Houston

We have reached a limit in our ability to reduce the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional evaluation, prevention, and treatment strategies for the top 5 cardiovascular risk factors - hypertension, diabetes mellitus, dyslipidemia, obesity and smoking. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite “normal” levels of these five risk factors as traditionally defined. An understanding of the other 395 other CHD risk factors, as well as a more logical and in depth review of these top five risk factors are required. Within the top 5 CHD risk factors the items that should be included are 24 hour ambulatory blood pressure monitoring, advanced lipid profile testing, dysglycemic parameter measurements, visceral obesity evaluation with effects of adipokines and inclusion of lab tests to evaluate the three finite vascular endothelial responses including inflammation, oxidative stress and immune vascular dysfunction. An understanding of translational cardiovascular medicine to correlate the CHD risk factors to the presence or absence of vascular injury and disease with non - invasive vascular testing will allow for early identification, prevention and treatment of CHD and CVD.