Introduction: The major causes of atherosclerotic cardiovascular disease (CVD) are known. There has been some progress with regards to control of tobacco smoking, hypertension and hyperlipidaemia in recent decades. Despite the fact that control of these unequivocally reduces risk, clinical audits such as EuroAspire and SURF1,2 continue to show inadequate risk factor recording and control. Levels of overweight and consequent diabetes continue to increase.
The great Geoffrey Rose taught us that a small reduction in risk at population level will have a larger impact on population health than a more intense intervention applied to a small number of very high-risk persons, even though such individuals should be identified as they may gain much as individual people.3 This has led to a widespread realisation that population and high-risk strategies are complementary and not competitive. Rose also stated that “The primary determinants of disease are mainly economic and social, and therefore its remedies must be economic and social. Medicine and politics cannot and should not be kept apart”.3
For verified healthcare professionals
Log in or register for free to read this article. HPN is for healthcare professionals, so new accounts are verified by our team.
