Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:1819-1824
© 1999 American Heart Association, Inc.
Brief Review |
Coronary Heart Disease: Reducing the Risk
The Scientific Background to Primary and Secondary Prevention of Coronary Heart DiseaseA Worldwide View
From the Institute of Arteriosclerosis Research and Institute of Clinical Chemistry and Laboratory Medicine (G.A., P.C.), University of Münster, Münster, Germany; the Department of Clinical and Experimental Medicine (F.J., M.M.), University of Naples, Naples, Italy; and the University of London (B.L.), London, UK.
Correspondence to Prof Gerd Assmann, International Task Force for Prevention of Coronary Heart Disease, Heerdestraße 9, 48149 Münster, Germany. E-mail chdtask@uni-muenster.de
Key Words: atherosclerosis • risk factors • coronary heart disease
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Introduction |
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Coronary heart disease (CHD) is the major cause of death in most developed countries and in many developing countries. The clinical complications of CHD lead to substantial disability and are a main source of the rising cost of health care. While CHD incidence is decreasing in western Europe, the United States, and Australia, it is steeply increasing in central and eastern Europe and, to some extent, in Asia and Africa.1 2 3 4 Worldwide, the need for more effective preventive strategies against CHD has become urgent and cannot be postponed. Much has been learned about preventive policies, both at the population and the individual level, in the past decade. The International Task Force for Prevention of CHD has developed an updated document that takes into account the results of the recent, major, lipid-lowering trials of primary and secondary prevention. Clinical and quantitative approaches are provided to assess the global risk of CHD according to classic and newly recognized risk factors and thereby to assign an appropriate level of intervention against risk factors. This targeted strategy maximizes the use of dietary methods and provides clear indications for drug treatment.
The primary importance of improving health-related behavior in the population as a whole is emphasized. In the present document, the undervalued scope for preventive care at the individual clinical level is the major theme; it is based on the selection and management of persons whose level of risk cannot adequately be reduced by presently available population measures.
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Risk Factors for CHD |
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Age, sex, and personal and family history of
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