New Concepts in the Prevention and Treatment of Coronary Heart Disease

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. A more logical and in depth understanding is required of these top five risk factors including the evaluation of 24 hour ambulatory blood pressure monitoring, advanced lipid profiles, dysglycemic parameters, visceral obesity with effects ofadipokines and of the three finite vascular endothelial responses which include inflammation, oxidative stress and immune vascular dysfunction to the infinite number of insults. Understanding 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.