TABLE 8.
Implementation of Clinical Practice Guidelines for Targeted Early and Sustainable Prevention of CMBCD*
| CMBCD Target | Timing by CMBCD Stage† | Clinical Practice Guideline Topics (Ref. #) |
|---|---|---|
| Behavioral | Early: 1 > 2 > 3 > 4 | Weight loss (137) |
| Healthy eating and physical activity (138) | ||
| Modifiable cardiovascular risk factors (139) | ||
| Obesity | Early: 1 > 2 > 3 > 4 | Comprehensive (114) |
| Pharmacotherapy (140) | ||
| Type 2 diabetes (141) | ||
| Cardiovascular risk (142,143) | ||
| Diabetes | Early: 1 > 2 > 3 > 4 | Comprehensive (144) |
| Nutrition (148) | ||
| Algorithm (145) | ||
| Cardiovascular (102,145,149) | ||
| Hyperglycemia (146) | ||
| Comorbidities (150) | ||
| Lifestyle (147) | ||
| Transcultural (151) | ||
| Cardiovascular disease | Late: 3 > 4 | Hypertension (152) |
| Coronary heart disease (153–155) | ||
| Heart failure (156–158) | ||
| Atrial fibrillation (45) | ||
| Cardiovascular disease | Late:4 | Coronary revascularization (159) complications |
| Ventricular arrhythmias and sudden death (160) | ||
| Advanced heart failure and transplantation (161) |
*
See Central Illustration for schematic representation. For primary drivers, there are no evidence-based clinical practice guidelines/clinical practice algorithms relevant for health care professionals on genetic or environmental interventions.
†
Timing for preventive care actions should be as early as possible. Behavioral, obesity, and diabetes targets can still be addressed at all stages. Cardiovascular disease with or without complications are addressed in later stages. Stage 1 is “risk”; stage 2 is “pre-disease”; stage 3 is “disease”; and stage 4 is “complications.”