Preventive Measures in Cardiology: Behavioral and Environmental Determinants of Cardiovascular Disease

Cardiovascular disease (CVD) remains the leading cause of global mortality. As of 2017, more than 17 million deaths were attributed to CVD, with over 360 million disability-adjusted life years lost, making CVD the highest-burden disease worldwide. As this burden continues to rise, it is essential to understand how behavioral and environmental conditions predispose individuals to CVD within socioeconomic and environmental contexts. In this review, the term “lifestyle factors” refers to health behaviors influenced by socioeconomic and environmental conditions. Using a health equity lens, this review examines how behavioral and environmental factors are linked to structural disparities, contributing to unequal distributions of cardiovascular risk.

Key risk factors of CVD include hypertension, diabetes, obesity, poor diet, physical inactivity, tobacco use, and alcohol use. Prevention strategies focus on health behavior modifications that may address multiple risk factors simultaneously. Sustained physical activity (PA) has been shown to lower cardiovascular mortality. Likewise, consumption of whole grains, fruits, vegetables, proteins, and omega-3 fatty acids may decrease cardiovascular mortality. However, the ability to adopt protective behaviors and avoid detrimental exposures varies across populations due to distinct neighborhood conditions, environmental conditions, and resource availability. Therefore, cardiovascular risk is often observed in structurally disadvantaged settings with increased exposure and limited access to protective conditions.

CVD is a multifactorial disease characterized by interactions among behavioral, biological, and environmental factors. Prevention strategies that integrate individual behaviors with social and environmental conditions may substantially alleviate the global burden of CVD and reduce cardiovascular inequities.