ABSTRACT
Tertiary prevention is implemented in symptomatic patients with advanced disease to reduce the severity of disease, mitigate disease-related complications, improve quality of life with decreased symptoms and suffering, optimize outcomes, and decrease mortality. In cardiometabolic-based chronic disease (CMBCD), the thrust of any intervention is to prevent development and progression of metabolic drivers (e.g., abnormal adiposity, dysglycemia, hypertension, and dyslipidemia) that culminate in cardiovascular derangements (e.g., atherosclerosis, heart failure (HF), and atrial fibrillation). In patients with advanced CMBCD, lifestyle modification as tertiary prevention can effectively address underlying metabolic pathways leading to complications, in order to improve quality of life. This chapter will focus on lifestyle interventions for type 2 diabetes complications and symptomatic cardiovascular disease as part of a comprehensive chronic care model that also includes indicated and judicious pharmacotherapy and procedures.
