Atlas of Cardiometabolic Risk PDF

Preface

Cardiovascular disease is the leading cause of death and disability worldwide. Although our understanding of this disease has progressed enormously, we have much to improve in identification of the disease and applying optimal treatments to prevent progression of disease and its consequences.

Beginning nearly 50 years ago, the Framingham Heart Study forever changed our approach to coronary artery disease by identifying major risk factors for myocardial infarction (MI) – namely hypertension, smoking, hypercholesterolemia, diabetes and a family history of MI. Since then, countless other risk factors and markers of disease have been identified. Our current approach to prevention (either primary prevention of a first event, or secondary prevention of recurrent events) is largely focused on controlling these individual risk factors. This single risk factor approach has led to multiple classes of drugs to treat each condition, and guidelines are developed centered on improvements of each one (e.g., hypertension – JNC VII, or the ADA) In addition, decades ago, the United States government established national programs, such as the National Cholesterol Education Program (NCEP) that develops guidelines for management of cholesterol.

A new approach is emerging however – that looks not at individual risk factors, but at the overall risk of disease in a patient. This involves looking at a long list of contributing risk factors – to assess a patient's overall cardiometabolic risk. It is this new approach to diagnosis and management that this book embraces. We aim to provide the best possible care to our patients, and taking this comprehensive approach is the best strategy to do so.

We cover many aspects of cardiometabolic risk in this Atlas. The initial chapters delve into the new understanding of the pathophysiology of the cardiometabolic risk, with colorful illustrations of the various pathways involved. Then, we cover many of the markers of cardiometabolic risk that can be used to identify patients in clinical practice. The final chapters review the newest trial data on the natural history of the disease with clinical outcomes of patients, as well as a brief overview of all the current treatments for cardiometabolic risk. We hope that this book will provide clinicians with a readily accessible guide to this important disease, that will help in caring for this large group of patients.