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(Circulation. 2008;117:3031-3038.)
© 2008 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Beyond Established and Novel Risk Factors

Lifestyle Risk Factors for Cardiovascular Disease

Dariush Mozaffarian, MD, DrPH; Peter W.F. Wilson, MD; William B. Kannel, MD, MPH

From the Division of Cardiovascular Medicine and Channing Laboratory, Brigham and Women’s Hospital and Harvard Medical School, and Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, Mass (D.M.); Department of Medicine, Emory University, and Atlanta VAMC Epidemiology and Genomic Medicine, Atlanta, Ga (P.W.F.W.); and the Framingham Heart Study, Boston University School of Medicine, Boston, Mass (W.B.K.).

Correspondence to D. Mozaffarian, MD, DrPH, 665 Huntington Ave, Bldg 2-319, Boston, MA 02115. E-mail dmozaffa@hsph.harvard.edu

Key Words: cardiovascular diseases • diet • exercise • obesity • prevention

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Dyslipidemia, hypertension, and diabetes mellitus have been appropriately highlighted as established predictors of cardiovascular disease. These risk factors have become preeminent targets for influencing cardiovascular risk; their assessment, treatment, and monitoring are major emphases of clinical care, research investigation, treatment guidelines, organization position papers, and measures of physician and hospital performance. Notably, lifestyle risk factors, including dietary habits, physical inactivity, smoking, and adiposity, strongly influence the established cardiovascular risk factors and also affect novel pathways of risk such as inflammation/oxidative stress, endothelial function, thrombosis/coagulation, and arrhythmia. Furthermore, modest alterations of these lifestyle risk factors are achievable and have substantial effects on cardiovascular risk. Thus, basic lifestyle habits should be considered fundamental risk factors for cardiovascular disease. Although efforts to combat established and novel risk factors with pharmacological treatments are important and should continue, we call for a systematic rebalancing of current research, clinical care, and policy efforts to focus more on lifestyle. The rising costs of healthcare and the epidemics of overweight and obesity highlight the inadequacies of our current strategy. Substantially more resources should be directed toward research on lifestyle risk factors, their determinants, and effective interventions to change them. The clinical evaluation and treatment of dietary, physical activity, and smoking habits must become as routine and familiar as assessment of blood pressure, cholesterol, and glucose levels. Major policy initiatives and reimbursement guidelines must also be rebalanced to emphasize lifestyle risk factors.

	Established Cardiovascular Risk Factors

 
Cardiovascular diseases are leading causes of death and disability among men and women in nearly all nations.¹ . . . [Full Text of this Article]

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