Preventing premature cardiovascular mortality: the role of lifestyle interventions and pharmacotherapy—a narrative review

Cardiovascular diseases (CVD), including coronary heart disease, cerebrovascular disease, and peripheral artery diseases, are the leading global cause of premature mortality in adults. Addressing CVD aligns with the United Nations Sustainable Development Goals aiming to reduce premature deaths by one-third by 2030 through lifestyle and pharmacological interventions. Major risk factors for CVD are categorized into lifestyle and genetic factors. Lifestyle factors such as elevated cholesterol, hypertension, high body mass index, smoking, poor dietary habits, and physical inactivity significantly increase CVD mortality. Conversely, genetic predisposition strongly influences individual risk, often amplified by unhealthy behaviors. Primary prevention strategies, including adherence to Dietary Approaches to Stop Hypertension (DASH) and Mediterranean Diet (MD), regular physical activity, and smoking cessation, have demonstrated effectiveness in reducing CVD incidence and mortality. Secondary prevention emphasizes pharmacological interventions, specifically aspirin and statin therapies, non-statin agents, antihypertensive, all of which significantly decrease recurrent cardiovascular events among high-risk individuals. Although cardiovascular screening practices remain debated, targeted screening informed by precision medicine approaches and artificial intelligence shows promise in stratifying risk effectively. This review synthesizes evidence on these preventive strategies, underscoring their integrated role in reducing premature CVD-related mortality, while recognizing the need for further implementation research to optimize preventive healthcare outcomes.