RT Journal Article SR Electronic T1 Contributions of treatment and lifestyle to declining CVD mortality: why have CVD mortality rates declined so much since the 1960s? JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 159 OP 162 DO 10.1136/heartjnl-2012-302300 VO 99 IS 3 A1 Martin O'Flaherty A1 Iain Buchan A1 Simon Capewell YR 2013 UL http://heart.bmj.com/content/99/3/159.abstract AB Developed countries have enjoyed substantial falls in cardiovascular disease (CVD) mortality. However, low and middle income countries are drowning in a rising tide of CVD and other non-communicable diseases. Current and future trends in CVD mortality will therefore require increasing attention in the 21st century. The success of clinical cardiology in providing evidence-based cost-effective treatments should be celebrated. However, the growing understanding of CVD mortality trends highlights the crucial role of tobacco, diet, alcohol and inactivity as key drivers. Pro-active public health approaches focused on ‘upstream’ population-wide policies are increasingly recognised as being potentially powerful, rapid, equitable and cost-saving. However, the future political challenges could be substantial.