Sofia declaration for prevention of cardiovascular diseases and type 2 diabetes mellitus: A scientific statement of the international college of cardiology and international college of nutrition

Background: There has been persistent emphasis from various health agencies including United Nations on the prevention of cardiovascular diseases (CVDs) and other chronic diseases. This review focusses on the emergence of CVDs and other chronic diseases as well as on modern strategies for their prevention. Methods: A systematic and narrative review was conducted using such reference databases as MEDLINE (PubMed), Web of Science and EBSCO, with additional secondary sources and grey literature searching. Opinions of experts were also sought and discussions followed. Results: The prevalence of primary risk factors for most chronic diseases is rapidly increasing in low and middle income populations due to the on-going economic development and progress. There is a decrease in such risk factors in the developed countries as due to education and adoption of preventive strategies result in a reduction in CVD mortality. Hypertension (5-10%), type 2 diabetes (3- 5%) and CAD (3-4%) are very low in the adult rural populations of India, China, and in the African subcontinent which has less economic development. It seems that it is not poverty, but the lack of health education, possibly due to ineffective policies of national and local governments. In urban and immigrant populations of India and China, which are economically better off, NCDs are significantly higher than they are in some of the highincome populations. Health education and promotion of healthier lifestyle and behaviour appear to be important for prevention in such countries. Conclusion: These findings may require modification of the existing American and European guidelines, proposed for the prevention of CVDs and other chronic diseases, in highincome populations.