Lesson Objectives:

• Understand primary vs. secondary prevention of cardiovascular disease.

• Discuss the impact of diet, exercise, and risk factor modification.

• Review the role of pharmacologic prevention (aspirin, statins, SGLT2 inhibitors, GLP-1 agonists).

Primary vs. Secondary Prevention

✔️ Primary Prevention – Prevents first cardiac event.
✔️ Secondary Prevention – Prevents recurrence in those with existing disease.

Lifestyle Interventions (AHA/ACC Guidelines)

✔️ Diet:

• Mediterranean diet (high in omega-3s, fiber, low saturated fats).

• DASH diet (low sodium, high potassium).

• Avoid trans fats & processed carbs (reduces LDL & inflammation).

✔️ Exercise:

• 150 min/week moderate-intensity aerobic exercise.

• Resistance training twice a week (reduces BP & improves metabolism).

✔️ Weight Management:

• Target BMI <25 kg/m².

• >5% weight loss significantly improves BP, cholesterol, and glucose control.

Pharmacologic Prevention – Who Needs What?

✔️ Aspirin (ASA) for Primary Prevention:

• Only in high-risk patients (ASCVD >10%).

• Not recommended for routine use in low-risk adults due to bleeding risk.

✔️ Statins for Cholesterol Management:

• High-intensity (Atorvastatin 40-80 mg, Rosuvastatin 20-40 mg) for ASCVD, LDL >190.

• Moderate-intensity for diabetes (regardless of LDL).

✔️ Newer Therapies (for High-Risk CVD Patients)

• SGLT2 inhibitors (Empagliflozin, Dapagliflozin) – Reduce HF risk.

• GLP-1 agonists (Liraglutide, Semaglutide) – Reduce MACE (major adverse cardiac events).