Roadmap to a career in preventive cardiology

Fundamentally, the practice of preventive cardiology requires knowledge of cardiovascular physiology, epidemiology, genetics, metabolism, anatomy, multimodality imaging, stress testing, pharmacology, cardiac rehabilitation and lifestyle management.1 Unfortunately, preventive cardiology is not widely recognised or standardised, though some have outlined the basic components necessary for success in the field.2 3 We feel that expertise in the following domains is, at a minimum, necessary for the practice of preventive cardiology: ASCVD risk assessment Primary and secondary prevention strategies Diabetes Hypertension Lipid metabolism and therapeutics Vascular medicine Obesity and weight management Nutrition, physical activity and smoking cessation counselling Cardiac imaging (coronary artery calcium scoring, coronary CT angiography, carotid intima-media thickness, echocardiography, stress testing, cardiopulmonary exercise testing) Cardiac rehabilitation Research methods and interpretation Additional training outside of general cardiology fellowship is usually desirable to attain proficiency. Dedicated preventive cardiology training programmes throughout Europe are sparse, though the European Association of Preventive Cardiology (EAPC) recently put forth a document to better standardise, structure, deliver and evaluate training across the continent.4 Figure 1. Preventive cardiology is arguably the most impactful subspecialty within cardiovascular medicine as practitioners have the ability to influence disease at both the individual and population levels.