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Rationale

Atherosclerotic cardiovascular diseases (CVDs), including heart disease and stroke, are the leading causes of mortality worldwide. The atherosclerotic illness develops insidiously, and clinical manifestations often become evident in its advanced stages.  This explains why CVDs represent one of the major challenges to the health systems and considerable efforts are profused to treat clinical manifestations of CVDs. These efforts have granted significant advances with actual improvements in patients’ outcome, quod ad vitam and valitudinem.

Despite the success of the pharmacological, interventional, and surgical treatment of the CVDs,  all these therapies cannot modify the epidemiological impact of the disease. Moreover, the cost of current health systems grows exponentially with the widespread use of complex diagnostic procedures, as well as with population aging. At present, the strategy of prevention, which attempts to modify some patho-physiological factors related to the genesis of the disease, seems to be the only way to limit the epidemic growth of CVDs.

Cardio-metabolic risk is a cluster of risk factors indicative of a patient’s overall risk for CVD and type-2 diabetes. They include obesity, physical inactivity, smoke, alcohol abuse, abnormal lipid metabolism, hyper-glycaemia, and arterial hypertension. Educational programs and lifestyle interventions represent effective tools for reducing cardio-metabolic risk profile and incidence of CVDs.  Such a prevention strategy is individually tuned and requires an expensive organization of the health systems. A rationale alternative to  intensive individual coaching is the development of systems for self-learning and self-monitoring. These systems may help people to change and maintain their lifestyle providing tailored suggestions about nutrition, weight, physical activity, fatigue, and stress according to daily surveys.  Data collected by such coaching systems could be analysed and interpreted by health care professionals so as to support decision making targeted to the specific individual conditions. This approach has the potential to result highly cost-effective and might foster the diffusion of self-coaching systems with favourable impact on social, physiological, and environmental factors that, at present, remain barriers for the success of large-scale preventive intervention on CVD and diabetes.