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cardiovascular disease prevention
Prevention of cardiovascular disease in asymptomatic people
  1. Guy De Backer
  1. Correspondence to Professor Guy De Backer, Ghent University, University Hospital, De Pintelaan 185, Gent B-9000, Belgium; guy.debacker{at}ugent.be

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Mortality due to cardiovascular disease (CVD) has been declining rapidly in most Western European countries since the 1970s or '80s.1 This has resulted in a significant increase in life expectancy not only at birth but also in adult and elderly people. The increase in life expectancy during the last decades in Europe is for the large majority related to the decline in CVD mortality.2 Thus, one could ask the question whether much more attention should be given to CVD prevention. What is the rationale for requesting continuous and even greater efforts in CVD prevention?

Rationale for the prevention of cardiovascular disease

CVD is still the leading cause of premature death and disability in industrialised countries, and is taking the lead in developing countries. This results in loss of productivity and in escalating costs of healthcare. CVD due to atherothrombotic lesions is largely preventable by adopting healthy lifestyles and by controlling the major risk factors.

A comprehensive plan for prevention of CVD should include:

  • a population strategy for altering, in the whole community, those lifestyle and environmental factors and their socioeconomic determinants that are the underlying causes of the mass occurrence of CVD

  • a high risk strategy for the identification of high risk people and action to reduce their risk factor levels, and

  • a plan for the prevention of recurrent events in patients with established CVD. In this report prevention of CVD in asymptomatic people is discussed as part of the high risk strategy; however, the population approach is of paramount importance and should always complement the other.

Given the limited resources that are available for prevention in most health care systems, priorities have to be set and the resources that are available should be used as efficiently as possible, which means that one should adapt the intensity of interventions in accordance with the total risk …

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