When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention

Author:

D’Ascenzi Flavio12,Sciaccaluga Carlotta1,Cameli Matteo1,Cecere Annagrazia3,Ciccone Marco M3,Di Francesco Simona45,Ganau Antonello6,Imbalzano Egidio6,Liga Riccardo7,Palermo Pietro8,Palmiero Pasquale9,Parati Gianfranco1011,Pedrinelli Roberto7,Scicchitano Piero3,Zito Annapaola6,Mattioli Anna V12

Affiliation:

1. Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy

2. Department of Medicine, University of Pittsburgh, USA

3. Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy

4. Department of Medical and Oral Sciences and Biotechnologies, G. D’Annunzio University of Chieti-Pescara, Italy

5. Department of Urological, Biomedical and Translational Sciences, Federiciana University, Italy

6. Department of Clinical and Experimental Medicine, University of Messina, Italy

7. Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy

8. Centro Cardiologico Monzino, IRCCS, Italy

9. ASL Brindisi, Cardiology Equipe, District of Brindisi, Italy

10. Department of Cardiovascular, Neural, and Metabolic Sciences, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Italy

11. School of Medicine and Surgery, University Milano-Bicocca, Italy

12. Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy

Abstract

Abstract Cardiovascular diseases represent a major health problem, being one of the leading causes of morbidity and mortality worldwide. Therefore, in this scenario, cardiovascular prevention plays an essential role although it is difficult to establish when promoting and implementing preventive strategies. However, there is growing evidence that prevention should start even before birth, during pregnancy, aiming to avoid the onset of cardiovascular risk factors, since events that occur early in life have a great impact on the cardiovascular risk profile of an adult. The two pillars of this early preventive strategy are nutrition and physical exercise, together with prevention of cardio-metabolic diseases during pregnancy. This review attempts to gather the growing evidence of the benefits of antenatal, perinatal and primordial prevention, discussing also the possibility to reverse or to mitigate the cardiovascular profile developed in the initial stages of life. This could pave the way for future research, investigating the optimal time and duration of these preventing measures, their duration and maintenance in adulthood, and the most effective interventions according to the different age and guiding in the next years, the best clinical practice and the political strategies to cope with cardiovascular disease.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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