Update in cardiology: vascular risk and cardiac rehabilitation.

As in other fields, understanding of vascular risk and rehabilitation is constantly improving. The present review of recent epidemiological update shows how far we are from achieving good risk factor control: in diet and nutrition, where unhealthy and excessive societal consumption is clearly increasing the prevalence of obesity; in exercise, where it is difficult to find a balance between benefit and risk, despite systemization efforts; in smoking, where developments center on programs and policies, with the electronic cigarette seeming more like a problem than a solution; in lipids, where the transatlantic debate between guidelines is becoming a paradigm of the divergence of views in this extensively studied area; in hypertension, where a nonpharmacological alternative (renal denervation) has been undermined by the SYMPLICITY HTN-3 setback, forcing a deep reassessment; in diabetes mellitus, where the new dipeptidyl peptidase-4 and sodium-glucose cotransporter type 2 inhibitors and glucagon like peptide 1 analogues have contributed much new information and a glimpse of the future of diabetes treatment, and in cardiac rehabilitation, which continues to benefit from new information and communication technologies and where clinical benefit is not hindered by advanced diseases, such as heart failure. Our summary concludes with the update in elderly patients, whose treatment criteria are extrapolated from those of younger patients, with the present review clearly indicating that should not be the case.

[Update on preventive cardiology and rehabilitation]. / Actualidades en cardiología preventiva y rehabilitación.

The aim of the Preventive Cardiology and Rehabilitation Section of the Spanish Society of Cardiology is to promote knowledge about and adoption of the lifestyle, therapy and rehabilitation program guidelines that are best able to improve cardiovascular health in the Spanish population. To achieve this aim, a number of working groups have carried out research into and provided education about the latest developments in cardiovascular prevention, and have provided information about these developments to all those affected, including physicians, healthcare workers, healthcare administrators and the general public. This year, the working group on smoking produced an key document that was presented to cardiologists in our Society; its intention was to provide a simple algorithm to help patients give up smoking that could be applied in only 3 minutes. The working group on cardiac rehabilitation gave a presentation on the true impact of rehabilitation on survival after percutaneous coronary intervention and heart failure. Also this year, the European Society of Cardiology published a major revision of guidelines on the treatment of dyslipidemia, which was welcomed by many but criticized by others. Our correspondent at the European Society reflects on the role and usefulness of these guidelines in practice.