Dietary, socio-economic and behavioral risk factors for recurrent acute Coronary Syndrome (ACS) events

Although cardiovascular disease mortality rates seem to decline, the increasing prevalence of Acute Coronary Syndrome (ACS) over time along with the aging of the population, will pose serious public health concerns and large economic burden. In Greece, cardiovascular disease (CVD) represents the 50% of mortality and 30% of the patients are re-hospitalized within the first six months after the first cardiac event, according to WHO report. A substantial number of these events has been attributed to various modifiable and preventable lifestyle factors. Dietary patterns, physical activity, life stress, smoking habits, socio-economic factors, even though they have long been discussed in primary prevention level, they are not well understood and appreciated in the spectrum of secondary ACS prevention and in combination with the established socio-economic status. Based on the retrieved information it was revealed that there is a vast evidence that secondary prevention of cardiovascular events cannot be accomplished simply through medical treatment, but it requires a multifaceted approach incorporating lifestyle modifications, too. Clinical trials and observational studies have demonstrated that adherence to the Mediterranean diet and moderate physical activity/week reduce the risk of a recurrent cardiac event by 50% and 30% respectively, smoking cessation reduces CVD mortality risk by 36%, 30% of ischemic heart disease and stroke is attributable to obesity, while 80% of CVD deaths occur in low and middle income countries. Public health policy endeavours should be directed to the establishment of an environment which will promote patients’ and their families’ quality of life, too.