Drug Therapies for the Primary Prevention of Cardiovascular Events: Trials and Errors

Blackburn entitled his introduction to the first Ancel Keys lecture "Ancel Keys, pioneer" and summarized Keys' astonishing array of work in nutrition and physiology, methods, and prevention, including the diet-heart hypothesis and efforts to bridge biology, preventive medicine, and public health. 2 As a result of his work and the work of many others over the last 50 years, the mortality rate from coronary heart disease (CHD) declined by about 50% between 1980 and 2000, a decline attributable in part to changes in medical treatments after coronary events and in part to changes in levels of risk factors in the population. In this lecture, as an admiring follower and a northwest settler, I consider some potential next steps in CHD prevention.