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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EReductions in cardiovascular mortality have been achieved via improved prevention, diagnosis, and treatment. However, costs have risen accordingly. A future emphasis on health promotion and disease prevention through research, education, and mitigation of disease-causing environmental factors holds the promise of improving outcomes and reducing the cost of treating CV disease.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Earrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiovascular disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecoronary artery disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eeducation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eenvironment\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Efuture\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eimaging\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eprevention\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Etherapeutics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Evalvular disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003ELeading experts in cardiology shared their visions for the future of cardiovascular (CV) disease management. Sophisticated imaging techniques, interventional technologies, and medical therapies are transforming the identification and treatment of arrhythmias, valvular diseases, and coronary artery disease (CAD). At the same time, a shift from a focus on treating disease to health promotion and disease prevention promises to reduce avoidable deaths from heart disease.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\u003Ch2 class=\u0022\u0022\u003ESophisticated Imaging and Robotic Technology to Transform Arrhythmia Therapy\u003C\/h2\u003E\u003Cp id=\u0022p-3\u0022\u003EAccording to Josep Brugada, MD, PhD, University of Barcelona, Barcelona, Spain, the medical field is moving from reactive, disease-based medicine to P4 medicine (personalized, predictive, preventive, participatory). In the next 10 to 15 years, the focus will be on highly sophisticated imaging technology, minimally invasive therapeutics, and personalized genomic medicine.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAlthough progress has been made in the detection and treatment of arrhythmias, therapy is not standardized to produce the same results across centers and regions. In the next years, it may be possible to automatically identify reentrant circuits with magnetic resonance imaging (MRI) and systematically ablate them using robotic technology.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003ECurrently, a variety of imaging systems and ablation methods are used for atrial fibrillation ablation, but only up to 70% of arrhythmias are successfully ablated. Prof Brugada predicted that a systematic approach using MRI anatomic map-guided ablation to identify and automatically ablate electrical channels will be used in the next decade.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere are 300\u2005000 sudden cardiac deaths (SCDs) among the general population each year, according to Prof Brugada. Several risk factors are known but many persons at risk are not identified. MRI could be used to identify abnormalities such as arrhythmogenic scars.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ENew technologies that may reduce the incidence of SCD include wide distribution of public access defibrillators and sophisticated pacemakers. Small leadless, heart movement\u2013powered pacemakers with wireless communication that can be implanted in the heart are also in development. Biological pacemakers using gene technology to convert normal heart cells into pacemaker cells and stem cells to repair injured areas of the heart are on the horizon. Novel therapeutic approaches using gene transfer, gene silencing, and gene editing techniques to cure genetic arrhythmogenic diseases are also under development.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EImproved Imaging and New Therapies for Future Management of Coronary Artery Disease\u003C\/h2\u003E\u003Cp id=\u0022p-8\u0022\u003ELooking into the future of CAD treatment, Christian JM Vrints, MD, Antwerp University Hospital, Antwerp, Belgium, envisions the advent of improved imaging, revascularization, and lipid-lowering technologies.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EImproved imaging of coronary arteries using coronary computed tomography angiography (CTA) can be expected in the future. CTA can detect, characterize, and quantify vulnerable plaques before they cause cardiac events [Maurovich-Hovat et al. \u003Cem\u003ENat Rev Cardiol\u003C\/em\u003E. 2014]. CT-derived fractional flow reserve (FFR\u003Csub\u003ECT\u003C\/sub\u003E) provides high diagnostic accuracy of hemodynamically significant CAD compared with invasive FFR and greater specificity compared with CTA [Norgaard BL et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E. 2014]. Dynamic CT myocardial perfusion imaging is being studied for identification of ischemic myocardium.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EThe focus in CAD is shifting from identifying vulnerable atherosclerotic plaques to evaluating the total plaque burden for coronary event risk estimation. The use of bioabsorbable stents shows promise for promoting long-term vascular healing [Karanasos A et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E. 2014].\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003ENew lipid-lowering agents with the potential to prevent CV events are emerging. The monoclonal antibody evolocumab has reduced low-density lipoprotein (LDL) levels and CV events when combined with standard therapy vs standard therapy alone [Sabatine MS et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E. 2015].\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003EProf Vrints presented an algorithm for the future management of CAD but cautioned that ischemic heart disease deaths may increase again if the ongoing obesity epidemic is not curbed (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Optimal medical therapy aiming at preventing ischemia, thrombosis, and plaque burden progression will be the cornerstone of the management of CAD. Whether early revascularization in case of severe ischemia is helpful in chronic stable CAD will be clarified by the ongoing ISCHEMIA trial.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Future Management of Coronary Artery DiseaseReproduced with permission from CJM Vrints, MD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1835354057\u0022 data-figure-caption=\u0022Future Management of Coronary Artery DiseaseReproduced with permission from CJM Vrints, MD.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16982\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-13\u0022 class=\u0022first-child\u0022\u003EFuture Management of Coronary Artery Disease\u003C\/p\u003E\u003Cp id=\u0022p-14\u0022\u003EReproduced with permission from CJM Vrints, MD.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-4\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EGrowth of Transcatheter Interventions for Valvular Heart Disease\u003C\/h2\u003E\u003Cp id=\u0022p-15\u0022\u003EAlain Cribier, MD, University of Rouen, France, presented his views about the future treatment of valvular heart disease (VHD). The role of interventional procedures for aortic stenosis (AS) and mitral regurgitation (MR) has been increasing since the early 1980s and is expected to grow by 30% over the next decade.\u003C\/p\u003E\u003Cp id=\u0022p-16\u0022\u003EThe advent of transcatheter atrial valve replacement (TAVR) for AS in 2002 has changed the landscape of interventional cardiology with more than 200\u2005000 procedures performed worldwide, and a 4-fold increase in the number of patients treated predicted in the next decade. TAVR is now the standard of care for inoperable patients with AS and an important alternative to surgical AVR for high-risk patients [Kapadia SR et al. \u003Cem\u003ELancet\u003C\/em\u003E. 2015; Mack MJ et al. \u003Cem\u003ELancet\u003C\/em\u003E. 2015]. Advanced valves and delivery systems are improving TAVR results, and a minimalist approach that reduces time in the hospital is becoming more common. Prof Cribier predicted that TAVR indications will expand and results will improve in the next decade (\u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Vision for the Future of Transcatheter Aortic Valve ReplacementAS, aortic stenosis; SAVR, surgical aortic valve replacement; TF-TAVI, transfemoral transcatheter aortic valve implantation.Reproduced with permission from A Cribier, MD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1835354057\u0022 data-figure-caption=\u0022Vision for the Future of Transcatheter Aortic Valve ReplacementAS, aortic stenosis; SAVR, surgical aortic valve replacement; TF-TAVI, transfemoral transcatheter aortic valve implantation.Reproduced with permission from A Cribier, MD.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16983\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \u003Cp id=\u0022p-17\u0022 class=\u0022first-child\u0022\u003EVision for the Future of Transcatheter Aortic Valve Replacement\u003C\/p\u003E\u003Cp id=\u0022p-18\u0022\u003EAS, aortic stenosis; SAVR, surgical aortic valve replacement; TF-TAVI, transfemoral transcatheter aortic valve implantation.\u003C\/p\u003E\u003Cp id=\u0022p-19\u0022\u003EReproduced with permission from A Cribier, MD.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-20\u0022\u003EEffective treatment for MR is an unmet clinical need, but innovative techniques for transcatheter mitral valve repair (TMVR) are dramatically increasing.\u003C\/p\u003E\u003Cp id=\u0022p-21\u0022\u003EThe greatest change in the management of VHD will be a considerable growth of transcatheter interventions. In patients with AS, advanced TAVR systems, improved operator technique, and a minimalist strategy will allow a fast expansion of indications to lower risk patients. For patients with degenerative and functional MR, interventional techniques, valve repair, and TMVR will continue to grow.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-5\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EShifting Focus to Prevention of Environmental Causes of Cardiovascular Disease\u003C\/h2\u003E\u003Cp id=\u0022p-22\u0022\u003EValentin Fuster, MD, Mount Sinai Hospital, New York, New York, USA, discussed the relationship between the environment and CV disease. As people age, environmental conditions contribute to CV and other diseases and high health care costs. In the United States and Europe, CV mortality rates have decreased since the 1980s; 50% of this decrease can be attributed to prevention and 50% to health care technology. The cost of treatment for CV disease is expected to increase from $273 billion in 2010 to $818 billion in 2030 [Heidenreich PA et al. \u003Cem\u003ECirculation\u003C\/em\u003E. 2011]. Prevention measures can go a long way toward decreasing these costs.\u003C\/p\u003E\u003Cp id=\u0022p-23\u0022\u003EAmong the top 25 diseases worldwide, of which one-third are related to the environment, ischemic heart disease is the most common [Kunzli N. \u003Cem\u003EEur Heart J\u003C\/em\u003E. 2015]. In addition to established risk factors, increasing evidence shows that air and noise pollution induce inflammation and oxidative stress in blood vessels, leading to obesity, diabetes, and CV disease [Munzel T et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E. 2015].\u003C\/p\u003E\u003Cp id=\u0022p-24\u0022\u003EPrograms throughout the world are using science and education to improve CV health. Programs such as these have the potential to reduce the number of CV deaths from avoidable causes (\u003Ca id=\u0022xref-fig-3-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F3\u0022\u003EFigure 3\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F3\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F3.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Avoidable Mortality Rates (Aged \u0026amp;gt;\u0026#x2005;60 Years) in 51 Selected Countries (1980\u0026#x2013;2011)Reprinted from The Lancet, Vol 385, Mathers CD et al, Causes of international increases in older age life expectancy, Pages 540-548, Copyright (2015), with permission from World Health Organization.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1835354057\u0022 data-figure-caption=\u0022\u0026amp;lt;div xmlns=\u0026amp;quot;http:\/\/www.w3.org\/1999\/xhtml\u0026amp;quot;\u0026amp;gt;Avoidable Mortality Rates (Aged \u0026amp;amp;gt;\u0026#x2005;60 Years) in 51 Selected Countries (1980\u0026#x2013;2011)Reprinted from \u0026amp;lt;em\u0026amp;gt;The Lancet\u0026amp;lt;\/em\u0026amp;gt;, Vol 385, Mathers CD et al, Causes of international increases in older age life expectancy, Pages 540-548, Copyright (2015), with permission from World Health Organization.\u0026amp;lt;\/div\u0026amp;gt;\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 3.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F3.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F3.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 3.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28\/9\/F3.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16984\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 3.\u003C\/span\u003E \u003Cp id=\u0022p-25\u0022 class=\u0022first-child\u0022\u003EAvoidable Mortality Rates (Aged \u0026gt;\u200560 Years) in 51 Selected Countries (1980\u20132011)\u003C\/p\u003E\u003Cp id=\u0022p-26\u0022\u003EReprinted from \u003Cem\u003EThe Lancet\u003C\/em\u003E, Vol 385, Mathers CD et al, Causes of international increases in older age life expectancy, Pages 540-548, Copyright (2015), with permission from World Health Organization.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-27\u0022\u003EOne such program, developed by Dr Fuster and colleagues, employs a stratified approach to sustaining health throughout a lifetime. This approach promotes CV health and prevention of disease progression at 3 different age ranges using educational and behavioral tools appropriate to the age range and physiologic background. The optimal time to motivate healthy behavior is between the ages of 3 and 5 years. Educational interventions on how the body and heart work, healthy food habits, physical activity, and emotional habits to avoid addiction are used at this time. This program has had beneficial effects on adiposity, with the greatest impact when started at the earliest age and maintained over 3 years. At the age range of 25 to ~\u200550 years, subclinical disease is evaluated with advanced noninvasive imaging modalities [Fernandez-Friera L et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2015; Baber U et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E. 2015]. Findings of subclinical disease can be used as motivation for lifestyle changes. After age 50 years, the entire individual is examined for systemic CV disease, including the neurovascular region for microvascular changes that might cause dementia.\u003C\/p\u003E\u003Cp id=\u0022p-28\u0022\u003ENew technologies are leading to a better understanding of CV disease and its causes. Individualized treatment is becoming possible with emerging imaging techniques and genetic therapies. The recognition of lifestyle and environmental causes of CV disease has led to a focus on health promotion and disease prevention with goals for reducing CV mortality worldwide.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/28\/9.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzl4c1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzl4c1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}