Cardiovascular Disease Epidemiology and Risk Factors: General Concepts

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. All nations in the world are impacted. The incidence and prevalence of CVD are rising throughout the world, and the socioeconomic cost of this epidemic is straining the health care budgets of all nations. Cardiovascular epidemiology has identified environmental, behavioral, and genetic factors that are associated with either (a) protection from cardiovascular disease (CVD) or (b) increased predisposition to this group of illnesses. Protective factors include regular exercise, increased serum levels of high-density lipoprotein cholesterol, Mediterranean diet, increased consumption of polyunsaturated fats, and moderate alcohol intake. Predisposing factors include increased burden of atherogenic lipoproteins (low-density lipoprotein cholesterol, remnant lipoproteins), smoking, hypertension, insulin resistance and obesity, diabetes mellitus, and heightened systemic inflammatory tone. Cardiovascular epidemiology has made possible the identification of treatable, reversible risk factors for CVD. By testing the impact of specific interventions on individual risk factors in prospective, randomized clinical trials, it has been possible to quantitatively determine the benefits of such treatments compared to either placebo or a different treatment. Cardiovascular epidemiology has shown that risk factors behave essentially the same way in both men and women and people of all races and ethnic groups. Great effort needs to be made to identify patients with risk factor burdens and treat them earlier, more cost effectively, and more aggressively so as to lower the rate of rise in global CVD.