Valentin Fuster, MD: Necessary Heart Disease Prevention


Why US patients are now in absolute need of proven measures to lessen their risk of cardiovascular burden.

Adult-based findings from the FAMILIA study, presented at the American Heart Association (AHA) 2019 Scientific Sessions in Philadelphia, showed both individual- and group-based heart disease prevention management courses were more beneficial for reduced patient risk than standard lifestyle management.

The findings, which were coupled with even more booming data from the child-based assessment of the Harlem-based trial, evidence the growing need for better cardiovascular disease prevention efforts in the face of a growing rate of patients and worsening mortality.

In an interview with MD Mag while at AHA 2019, study author Valentin Fuster, MD, PhD, Physician-in-Chief and Head of the Cardiovascular Institute at Mount Sinai, emphasized the need for societal adjustment toward more heart disease-preventive lifestyle practices.

MD Mag: How will the FAMILIA results affect physicians?

Fuster: I'm not sure it's an issue of physicians; it's an issue of society.

First of all, we have to be aware that we can do a lot for the underserved population. Up until now, it was though obesity, high blood pressure, diabetes—we cannot do anything about it. Absolutely wrong.

So, we need to really make society aware that we can have a significant impact in this population. This is no. 1.

No. 2, these are results in the adults, and we have even better results in the children. And that is a thing, in which we should start—as we talked about preventing disease or promoting health—we should start with children.

We surveilled, in Harlem, 600 children between ages 3-6, with a very intensive program of teaching health for 50 hours over 4 months. And the results were fascinating. Very significant improvements on the children who were intervened, compared with the controls.

So, what we are trying to tell society is it's better if we start by thinking about preventing disease, or promoting better health in childhood—rather than dealing with disease too late, which is what we're doing today.

MD Mag: Is better preventive healthcare a necessary change to address growing cardiovascular disease rates?

Fuster: Well, I don't think we have a choice. Today, dealing with disease too late is very expensive, and the outcomes are not good—it's the no. 1 killer today.

So it's very clear: if we want to have great benefit on health, at a lower cost, we have to go younger and younger, so there is no escape.

For many years, I have been a clinical investigator, dealing late into disease, trying to understand disease. Now, I'm doing the same thing with the same tools, but in younger people.

So in a way, I'm part of this transition, at least in understanding that this problem is really at a younger age where we can prevent things.

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