Should the preventive measures against cardiovascular diseases in Europe and North America be applied in Latin America?

The prevention of cardiovascular diseases is based on the management of known cardiovascular risk factors by pharmacological means or by modifying lifestyles. A reduction in cholesterol levels is associated with a lower incidence of cardiovascular events and mortality, in both primary or secondary prevention trials. A reduction in blood pressure also leads to a decrease in acute myocardial infarction and the incidence of stroke. Regular exercise is associated with better disease free survival and the effects of smoking cessation are well known. High homocysteine levels are also associated with cardiovascular disease. However, there are no prospective clinical trials showing a beneficial effect of homocysteine reduction on cardiovascular mortality. A change in the type of dietary fat should also be beneficial, but this has not been proven in prospective clinical trials. In Chile, cardiovascular diseases are the leading cause of death among adults and the prevalence of cardiovascular risk factors, including hyperhomocysteinemia is similar to that of European or North American populations. Successful primary and secondary prevention programs to manage these risk factors have been developed in Chile. Therefore, the criteria applied in North America and Europe for the prevention of cardiovascular diseases, should be applied with slight modifications, in Latin American Countries.