Dietary prevention of ischaemic heart disease--a policy for the '80s.

The two daughters of the Greek god of healing, Asklepios, represent contrasting attitudes to medical care: Panacea's name has been translated as Cure-all and Hygieia's as Health. Neither approach alone could overcome the problem of ischaemic heart disease, which led to 156 000 deaths in England and Wales in 1976, proportionately more in Scotland, and much acute and chronic sickness. The valued contributions of coronary care units and of coronary artery surgery in individual management of patients have been estimated to reduce overall mortality from ischaemic heart disease by 4% and (on generous assumptions) 4-5% respectively.12 Medium term trials indicate a place for drug treatment with beta adrenergic blockers,3 and sulphinpyrazone4 and aspirin5 may possibly reduce the risk of reinfarction in patients with ischaemic heart disease. But the need for primary prevention is inescapable.