Population-level changes to promote cardiovascular health

Abstract

Background: Cardiovascular diseases (CVD) cause 1.8 million premature (<75 years) death annually in Europe. The majority of these deaths are preventable with the most efficient and cost-effective approach being on the population level. The aim of this position paper is to assist authorities in selecting the most adequate management strategies to prevent CVD. Design and Methods: Experts reviewed and summarized the published evidence on the major modifiable CVD risk factors: food, physical inactivity, smoking, and alcohol. Population-based preventive strategies focus on fiscal measures (e.g. taxation), national and regional policies (e.g. smoke-free legislation), and environmental changes (e.g. availability of alcohol). Results: Food is a complex area, but several strategies can be effective in increasing fruit and vegetables and lowering intake of salt, saturated fat, trans-fats, and free sugars. Tobacco and alcohol can be regulated mainly by fiscal measures and national policies, but local availability also plays a role. Changes in national policies and the built environment will integrate physical activity into daily life. Conclusion: Societal changes and commercial influences have led to the present unhealthy environment, in which default option in life style increases CVD risk. A challenge for both central and local authorities is, therefore, to ensure healthier defaults. This position paper summarizes the evidence and recommends a number of structural strategies at international, national, and regional levels that in combination can substantially reduce CVD.

Managing Sedentary Behavior to Reduce the Risk of Diabetes and Cardiovascular Disease

“…However, there is the need to consider what might be acceptable, cost-effective and implementable populationwide prevention strategies, in order to reduce T2D and CVD risk and burden. This is required to address a growing problem that is well beyond the capacities of clinically-based systems to address [69,[77][78][79]]. …”

Common Modifiable and Non-Modifiable Risk Factors of Cardiovascular Disease (CVD) among Pacific Countries

“…shows that Pacific islanders are more likely to have CVD if they don't adopt a healthy lifestyle [19]. In the Pacific islands, culture plays an important role on the three different ethnic groups, namely Melanesians, Polynesians, and Micronesians, way of living.…”

2016 European Guidelines on cardiovascular disease prevention in clinical practice

“…311,495,498 These have led to successful reductions in trans fats 499 and salt, 495,499 -501 the latter likely leading to decreases in BP. 501 Mandatory upper limits harmonized across the EU will ensure that all EU consumers are equally protected.…”

“…Rapid reductions in CV events can be seen after changes in diet at the population level. 497,510 Stakeholders, including health care professionals, have a shared responsibility for population-based approaches and can help to promote healthy diets and environments 495,498 (Figure L in web addenda 504 ).…”

“…495,504 Ideally, health education should be part of the school curriculum. Workplace dietary modification interventions alone and in combination with nutrition education or environmental changes have shown improvements in the consumption of fruits and vegetables and/or fats.…”