Department of Cardiology, University Hospital Mustapha, Algeria

Inactivity and a sedentary lifestyle impact more than half of the world's population. Despite the costs that obesity and diabetes place on our society, there is a low level of knowledge about cardiovascular disease as a result. For these people, it is crucial to practise primary cardiovascular disease prevention.

Inactivity and a sedentary lifestyle impact more than half of the world's population. Despite the costs that obesity and diabetes place on our society, there is a low level of knowledge about cardiovascular disease as a result. Public awareness efforts centred on these messages have improved citizen outcomes in industrialised nations. On the other side, the loss of our cultural icons, such as the traditional Mediterranean diet, has led to an epidemic rise in the number of overweight and obese people in our society. Therefore, it is crucial for these people to practise primary cardiovascular disease prevention.

To determine if cardiovascular primary prevention based on dietary, physical activity, and therapeutic education of Algerian patients without documented cardiovascular disease is feasible in our daily practise after determining their overall cardiovascular risk.

In 2008, 318 women (61.5%) out of a cohort of 517 patients with a mean age of 58.9 12.2 years participated in an observational prospective multicenter study. The evaluation of lipid profile, office blood pressure, fasting blood glucose, and anthropometric indicators.

To evaluate left ventricular hypertrophy (LVH) and other structural irregularities, they all underwent electrocardiogram (ECG) and echocardiography examinations. The distribution of the patients was based on their metabolic indices and risk factors for obesity. The European Score and other factors were used to determine the worldwide cardiovascular risk.the risk chart from the European Society of Hypertension and the low risk chart. The understanding of a healthy lifestyle in the present was evaluated.

Smoking was discovered in 36.7% of the men and 1% of the women who were assessed in the context of hypertension, diabetes, valvulopathies, dyspnea, non-cardiac surgery cardiovascular assessment, and chest discomfort.

Body mass index (BMI): 30.3 5.2 kg/m2 on average. Average waist measurement: 104.6 6 cm. We discovered hypertension in 87.6% of our patients. 59.3% of the patients had diabetes mellitus, with a mean HbA1C of 7.77 1.89. Smoking was identified as one of their risk factors in 36.7% of the men and 1% of the women. Body mass index (BMI): 30.3 5.2 kg/m2 on average. Average waist measurement: 104.66 cm. We discovered hypertension in 87.6% of our patients. 59.3% of the patients had diabetes mellitus, with a mean HbA1c of 7.77 1.89. Regarding dyslipidemia, HDL cholesterol level 0, 40, 08 g/l is in the lower limit, and triglyceridemia level 1.63 g/l is high. LDL cholesterol was at the upper limit of the normal range .

Regarding their risk factors, the majority of patients—453 (87.6%)—had hypertension, whereas 307 (59.4%) have Diabetes mellitus was observed in 266 patients (51.4%), along with a relationship between hypertension, diabetes mellitus, and low HDL cholesterol in 37.5% of the patients (Figure 3). In contrast to an ECG, we discovered higher left ventricular hypertrophy during an echocardiogram.

Biguanides are used by more than half of diabetics . distribution of lipid-lowering anti-platelet and anti-hypertensive medications (Figure 6). In addition to having only a primary level of education and low socioeconomic status, half of the patients are illiterate . Considering their socioeconomic condition, only one-third of the patients have enough understanding of diet and exercise, and two-thirds have information but are unable to engage in any exercise eating patterns of our patients.In contrast to our previous practises of using olive oil, our patients' diets focus mostly on carbs and saturated fatty acids. There is an excessive amount of sugar added to milk and coffee.This cohort's cardiovascular risk assessment revealed that the European Score low risk underestimated the risk compared to the ESH risk chart, and this implies that we employ both the European Score high risk and the ESH risk chart for our patients.

One third of the patients have high tri glyceridemia and low HDL cholesterol, and more than half of the patients are obese, diabetic, and hypertensive. heart disease risk Evaluation of this cohort revealed that the European Score low risk underestimated the risk relative to the ESH risk chart, and this implies that we employ both the European Score high risk and the ESH risk chart for our patients whenever possible [1]. organisation of More than half of the patients have obesity, diabetes, or hypertension, which increases the risk of cardiovascular disease and mortality [2]. We encourag them to at least lose weight in order to enhance their cardiovascular profile, as advised by the most recent preventative guidelines. According to the most recent European Guidelines on cardiovascular prevention [2], we encourage our patients in our day unit to walk for at least 30 minutes each day and do housework: Sedentary subjects should be urged to begin light-intensity aerobic exercise (50–63% of their maximum heart rate), and subsequently go on to moderate intensity activities like gardening. According to the current clinical practise guidelines for the prevention of cardiovascular disease [2], Algeria is one of the nations with the highest rates of greater than twice as high a risk as low-risk nations (CVD mortality >450/100 000 for males and >350/100 000 for women). The male to female ratio is also lower than in low-risk nations, indicating a serious issue for women. Albania, Algeria, Armenia, Azerbaijan, Belarus, Bulgaria, Bulgaria, Egypt, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Former Yugoslav Republic of Macedonia, Moldova, Russian Federation, Syrian Arab Republic, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan are among the nations with a very high risk of a terrorist attack. Age-adjusted coronary artery disease (CAD) mortality has decreased, especially since the 1980s, in high-income areas. Due to preventive measures, coronary artery disease rates in many European countries are currently less than half what they were in the early 1980s.

metrics like the effectiveness of anti-smoking laws [3]. The smoking ban in our nation is already in effect, but when it comes to physical activity, the goal should be to change attitudes at all levels, particularly with regard to women's sports, and to provide a safe atmosphere for them [4]. In accordance with the recommendations of the World Health Organization (WHO) global status report on non-communicable diseases 2010 [5], the 6th Joint Task Force guidelines [2] give healthcare professionals the tools they need to promote population-based strategies, incorporate them into national or regional prevention frameworks, and translate them into locally delivered healthcare services.

Our current task in Algeria is to implement the new cardiovascular prevention guidelines' key terms for physical exercise (2) All men and women should engage in regular physical activity as part of a healthy lifestyle, with at least 150 minutes per week of moderate activity, at least 75 minutes per week of vigorous activity, or an equivalent combination of the two. Any activity is preferable to doing nothing, and more activity is preferable to some. PA and movement instruction for young children should begin in preschool or kindergarten. At a minimum, 60 minutes should be spent moving each day in the classroom. Daily physical exercise is enhanced and encouraged by safe environments and good surroundings. Regular PA lowers the risk of numerous negative health effects across a wide range of Age range: Mortality from all causes and CVD is reduced by 20–30% in healthy people [6–8]. Numerous risk variables, including as hypertension, low-density lipoprotein cholesterol (LDL-C) and non-HDL-C, body weight, and type 2 diabetes, are positively impacted by physical exercise [5]. This is true for both men and women, and it also holds true for people of all ages, from young children to the very elderly. Unrelated to physical activity, a sedentary lifestyle is one of the main risk factors for CVD [9–11].

Although the American scales of risk, such as Framingham, or the European scales of risk, such as Euro Score and European Society of Hypertension, are very helpful for stratifying the risk in primary prevention of our patients and are a great educational tool for our students, we must adapt them to our population. For instance, rather than higher levels of LDL-C, the lipid profile of our often obese individuals had higher levels of triglycerides and lower levels of HDL cholesterol. To boost our patients' compliance with physical activity in particular, we also produce guidance in the languages that they speak.

To minimise morbidity and death due to preventable causes, education and support programmes to promote proper nutrition and physical exercise are crucial.to insufficient cardiovascular risk factor monitoring. We should collaborate with governments to reduce the aggressive marketing of high-calorie foods and to boost women's physical activity given the already rising rates of obesity, diabetes, and hypertension in our nation.

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2. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Alberico L, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice Massimo. European Heart Journal Advance. 2016.

3. Tatar Chentir NA, Allane S, Tir Y, Chentir MT.Why it is difficult to challenge lifestyle habits in an Algerian menopausal woman. Journal of hypertension. 2015; 33:16-34.

4. Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, et al. Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation 2007; 115:450-458.

5. Moran AE, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M, Murray CJ, et al. Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study. Circulation 2014; 129:1483-1492.

6. Lollgen H, Bockenhoff A, Knapp G. World Health Organization. Global status report on non-communicable diseases 2010.

7. Löllgen H, Böckenhoff A, Knapp G. Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med. 2009; 30: 213-224.

8. Moore SC, Patel AV, Matthews CE, Berrington de Gonzalez A, Park Y, Katki HA, et al. Leisure time physical activity of moderate to vigorous intensity and mortality: a large pooled cohort analysis. PLoS Med 2012; 9: 1001335.

9. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report, 2008. Washington, DC: U.S.

10.Talbot LA, Morrell CH, Fleg JL, Metter EJ. Changes in leisure time physical activity and risk of all-cause mortality in men and women: the Baltimore Longitudinal Study of Aging. Prev Med 2007; 45:169-176.

11.Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Lancet Physical Activity Series Working Group, . Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012; 380: 219-229

Derradji A,Chentir MT. The Serious Barriers to Physical Activity for Our Obese and Hypertensive Patients. Insights of Clinical and Medical Images 2022.