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preventionHeart and vascular (circulatory) disease can very often be prevented, or its onset postponed for many years. Prevention strategies focus on slowing the 'hardening of the arteries' process which, to some degree, affects everyone in the Western world from their middle-age onwards. Some individuals are even at risk of heart disease in their twenties, thirties and forties, particularly those with a strong family history of early heart disease or stroke.

Prevention Strategies

Strategies of prevention are divided into either the 'lifestyle' approaches alone, or with the additional use of modern medicines to slow up the process of atherosclerosis: the progressive 'hardening' or 'sludging up' of the arterial vessels.

Lifestyle approaches include regular exercise (at least 30 to 45 minutes, 3 to 5 times a week), not smoking, avoiding becoming overweight, and regularly eating a 'Mediterranean-style' diet: rich in salads, fruits, vegetables, cereals, fish, nuts and vegetable oils. Meat and dairy produce can be eaten as part of a healthy diet, but excessive amounts will tend to accelerate atherosclerosis. Modern medical practice includes the vigorous treatment of high blood pressure and high cholesterol levels. In some instances treatment with cholesterol-lowering medicines are required for those with normal levels but at high risk of developing a heart attack or stroke.

These patients include those with a strong family history of heart disease or stroke, those with multiple risk factors, and those who have already suffered from a heart attack, stroke or vascular disease elsewhere eg. peripheral arterial disease or an abdominal aortic aneurysm. Other medicines are also of help for those at high personal risk, although in New Zealand, PHARMAC does not always allow these to be available for 'free' use.

Assessment of Cardiovascular Risk

The assessment of an individual's own risk of developing heart or vascular disease is based on their family history, a variety of risk factors such as smoking, hypertension and high cholesterol levels, as well as a range of other modern risk factors and investigations. The traditional use of the Framingham-based 'colour chart' to assess risk is only the start of the optimal assessment of cardiovascular risk, which is best assessed by a clinician with an in-depth understanding of this rapidly developing area of medicine. Cardiovascular disease is the commonest cause of death and major morbidity in the whole of the Western world, including New Zealand, and each adult should have an appreciation of their own cardiovascular risk, and how they might optimally keep it at a low level.

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