Cardiovascular prevention in the context of chronic disease management and prevention Jaume Marrugat Grupo de Investigació...
Genetic Characteristics Risk Factors Disease Recurrences Primordial prevention Primary  Prevention Secondary Prevention In...
Conceptual issues in CDP <ul><li>There are dozens of chronic diseases that are not preventable. E.g., Crohn disease, arthr...
CDP is a public health affair <ul><li>It’s all about health promotion with population interventions </li></ul><ul><li>Ther...
CDP is a public health affair <ul><li>It’s all about health promotion population interventions </li></ul><ul><li>There is ...
CDP intervention basics <ul><li>Life style </li></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Nutrition (salt, fat,...
We are all going to die!  Lenny Bruce NY Cabaret stand-up comedian in the 60’s  (Ebrahim S. Int J Epidemiol. 2008; 37:225)...
CDP basics <ul><li>Clear non-biased information needs to reach the target population. </li></ul><ul><li>Question: how shou...
Calls to action published in medical journals: 1966–2007.  Source: Medline (Ebrahim S. Int J Epidemiol. 2008; 37:225) Glob...
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Jaume Marrugat de la Iglesia. Debates en Cardiología

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Debates en Cardiología; Novedades más relevantes. La prevención cardiovascular en el nuevo contexto de la gestión de enfermedades crónicas

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Jaume Marrugat de la Iglesia. Debates en Cardiología

  1. 1. Cardiovascular prevention in the context of chronic disease management and prevention Jaume Marrugat Grupo de Investigación en Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares Institut Municipal d’Investigació Mèdica (IMIM), Barcelona
  2. 2. Genetic Characteristics Risk Factors Disease Recurrences Primordial prevention Primary Prevention Secondary Prevention Inappropriate Life Styles Disease prevention POPULATION Population individuals Patients Patients Screening National Health Systems National Public Health systems
  3. 3. Conceptual issues in CDP <ul><li>There are dozens of chronic diseases that are not preventable. E.g., Crohn disease, arthritis, deafness, cataracts, dementia, organ failure…. The denomination can be misleading to the population. </li></ul><ul><li>It should be made clear that we are addressing cardiovascular , and respiratory diseases and some types of cancer exclussively . </li></ul>
  4. 4. CDP is a public health affair <ul><li>It’s all about health promotion with population interventions </li></ul><ul><li>There is little involvement of MDs and other health workers </li></ul><ul><li>The action will depend on the organizational capacity at country/region level </li></ul><ul><li>Depends on the politicians’ will…and budget </li></ul>
  5. 5. CDP is a public health affair <ul><li>It’s all about health promotion population interventions </li></ul><ul><li>There is little involvement of MDs and other health workers </li></ul><ul><li>The action will depend on the organizational capacity at country/region level </li></ul><ul><li>Depends on the politicians’ will…and budget </li></ul>It has been shown that 8.5 million deaths can be averted by salt-reduction strategy, and 5.5 million by implementation of 4 WHO tobacco-control interventions from 2006 to 2015. The cost would be 0.4$ and 0.5-1$ /person·year in low and high income countries, respectively. Asaria P. Lancet 2007;370:2044-53
  6. 6. CDP intervention basics <ul><li>Life style </li></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Nutrition (salt, fat, calories, vegetables, fruits) </li></ul></ul><ul><ul><li>Weight </li></ul></ul><ul><ul><li>Smoking bans </li></ul></ul><ul><li>What about multi-vitamin supplements? Many use them because they believe that they are “good for you”, but there is poor basis to sustain these beliefs </li></ul><ul><li>What will be the role of “polypills”: where, which drugs, at what costs? </li></ul>
  7. 7. We are all going to die! Lenny Bruce NY Cabaret stand-up comedian in the 60’s (Ebrahim S. Int J Epidemiol. 2008; 37:225) <ul><li>Averting deaths from certain CD may result in further increasing life expectancy, which in turn might result in more painful chronic disease prevalence (e.g., dementia) in our populations. </li></ul>
  8. 8. CDP basics <ul><li>Clear non-biased information needs to reach the target population. </li></ul><ul><li>Question: how should we address the “chronic” health differences among social classes? </li></ul>
  9. 9. Calls to action published in medical journals: 1966–2007. Source: Medline (Ebrahim S. Int J Epidemiol. 2008; 37:225) Global goals are a bit like a global New Year’s resolution—much easier to make than to keep.

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