Highlights the massive potential for cardiovascular disease prevention through risk factor modification supported by general practitioners, health policies, and environmental changes.
Several strands of evidence demonstrate the great potential for risk factor changes to reduce the burden of coronary heart disease (CHD). The CHD epidemic is not inevitable; the rapid changes in national CHD mortality show that these epidemics are modifiable. CHD is rare in countries where population risk factor levels remain low through adult life and in Western populations the small proportion of young and middle-aged adults with optimal levels of risk factors do not experience CHD as a major cause of death 1–4. This highlights the massive potential for prevention if the proportion of the population with optimal levels of major risk factors is increased. The identification of cardiovascular risk is one of the main targets of prevention and the first step to reduce modifiable risk factors. Risk is continuous and increases with age. A desirable risk level may be achieved by keeping risk factor values low through healthy lifestyle and where necessary, through pharmacological treatment. Risk charts and scores are key tools for the assessment of cardiovascular risk based on total absolute risk; the probability of developing the disease based on the main risk factor levels 5. Efforts to change diet, physical activity pattern and other aspects of lifestyle have traditionally attempted to educate individuals through schools, healthcare providers, worksites and general media. These efforts in individuals will continue to play a useful role, but to have a maximum effect, they need to be strongly reinforced by support from general practitioners (GPs) and cardiologists, and by a sustainable health policy and environmental changes 6. Given that the development of arteriosclerotic disease is asymptomatic, GPs, who observe their patients over years, are regarded as the appropriate persons to assess cardiovascular risk. They can provide important information on a patient’s health status and encourage patients to achieve and maintain a desirable level of risk factors by adopting a healthy lifestyle.
Simona Giampaoli (Tue,) studied this question.