How to Strengthen the Heart and Prevent Disease: A Comprehensive Approach to Health

Cardiovascular diseases (CVD) remain one of the leading causes of death and disability worldwide. However, a significant portion of these conditions can be prevented or significantly delayed through timely preventive measures. Strengthening the heart and maintaining its health is a task that requires a comprehensive and conscious approach throughout life. Modern cardiology offers numerous strategies for effective prevention, encompassing both traditional risk factors and emerging threats.

Basics of a Healthy Heart: Starting from Childhood

The origins of many CVDs are established in childhood [1]. National guidelines emphasize the importance of assessing risk factors, such as obesity and hypertension, as part of pediatric examinations [1]. The American Heart Association (AHA) proposes the concept of "cardiovascular health," which includes monitoring and managing the following components adapted to a child's age:

• Diet: healthy eating.
• Physical activity: sufficient level of daily activity.
• Screen time: limitation.
• Sleep: adequate and high quality.
• Smoking exposure: protection.
• Body Mass Index (BMI): maintaining a healthy weight.
• Blood pressure, cholesterol, and glucose: regular monitoring [1].

Early detection and timely intervention by pediatricians are critical for preserving cardiovascular health, laying the foundation for a long and healthy life [1].

Key Risk Factors and Their Control

Significant progress has been made in understanding and preventing coronary artery disease. New research in the fields of lipid lowering and hypertension control has expanded our knowledge of atherosclerosis prevention [2].

Risk factors for cardiovascular and cerebrovascular events (stroke) largely overlap [3]. The INTERHEART study confirmed that controlling these common factors is key to stroke prevention [3].

In addition to traditional factors, chronic inflammation plays a proven role in the development of atherosclerosis [4]. Individuals with chronic inflammatory conditions have an increased risk of CVD (coronary artery disease, heart failure) regardless of traditional factors [4]. Standard risk assessment tools often underestimate the true cardiac risk in this group, and insufficient awareness leads to inadequate preventive treatment [4].

An important factor is lipoprotein(a) [Lp(a)]. Elevated Lp(a) levels are an independent risk factor for coronary artery disease [8]. Cascade screening for elevated Lp(a) levels in relatives of patients with coronary artery disease has proven effective, especially when starting with patients in whom elevated Lp(a) levels have already been identified [8]. This emphasizes the importance of genetic predisposition and targeted examination.

Stroke Prevention: The Role of Screening and New Strategies

Atrial fibrillation (AF) is the most common cardiac arrhythmia, significantly increasing the risk of stroke, thromboembolism, and dementia [6]. Timely detection and treatment of AF are critical.

Systematic screening for AF, especially among the elderly, has shown high efficiency in detecting new cases of AF, allowing for the timely initiation of preventive measures [5].

Modern strategies for stroke prevention in AF include:

• ABC pathway (Atrial Fibrillation Better Care): improves stroke prevention outcomes by reducing mortality, stroke rates, and bleeding [6].
• 4S-AF scheme: assists in selecting personalized AF treatment [6].
• Left atrial appendage occlusion: an alternative for patients with contraindications to anticoagulant therapy [6].
• Digital health technologies: useful in the early detection of AF for timely prevention [6].

In addition to medical interventions, lifestyle habits significantly influence stroke risk [7]. Programs focused on lifestyle modification and daily activity, such as "Make My Day," have shown efficacy in reducing stroke risk in primary care [7].

A Comprehensive Approach to Heart Strengthening

Strengthening the heart and effective prevention of CVD require a comprehensive approach that combines medical recommendations and active individual participation:

• Healthy lifestyle: regular physical activity, balanced diet, smoking cessation.
• Regular medical check-ups: for early detection and control of risk factors (blood pressure, lipids, diabetes).
• Personalized risk assessment: accounting for specific factors such as chronic inflammation or genetic predisposition (Lp(a)) [4, 8].
• Screening and early intervention: especially for conditions like atrial fibrillation, where timely detection prevents complications [5, 6].
• Education and awareness: understanding the link between lifestyle, diseases, and CVD risk.

CVD risk changes dynamically [6], so preventive measures must be flexible and adapt to current health status.

The Future of Preventive Cardiology

The future of preventive cardiology promises even more personalized and effective approaches. The development of digital technologies and artificial intelligence opens new opportunities for early diagnosis and monitoring, as well as for creating individual prevention programs. Genetic studies, such as cascade screening for Lp(a), will play an increasingly important role in identifying high-risk groups, allowing preventive measures to be applied even before symptoms appear [8]. The integration of prevention programs into primary care will help reach more people and improve their long-term outcomes [7].

Sources

1. Preserving Optimal Cardiovascular Health in Childhood. (Pediatr Ann. 2018;47(12):e479-e486.)
2. Preventive cardiology. (Curr Opin Cardiol. 1999;14(5):427-431.)
3. Stroke Prevention. (StatPearls [Internet]. 2023 Jan.)
4. Cardiorheumatology: Prevention of Cardiovascular Disease in Inflammatory Disorders. (Med Clin North Am. 2022;106(2):315-327.)
5. Atrial Fibrillation Screening in Stroke Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (Rev Cardiovasc Med. 2025;26(1):11.)
6. Stroke prevention in atrial fibrillation: A narrative review of current evidence and emerging strategies. (Eur J Clin Invest. 2025;55(5):e14115.)
7. Make My Day – Stroke Prevention Based on Daily Activity Engagement in Primary Care – A Single-Blind Randomized Controlled Trial. (J Prim Care Community Health. 2025;16:21501327241253457.)
8. Lipoprotein(a) cascade screening in coronary artery disease. (Atherosclerosis. 2026;391:117621.)

Disclaimer: The information provided in this article is for reference purposes only and cannot replace professional medical advice. Always consult a qualified specialist for the diagnosis and treatment of diseases.