ABSTRACT
Death from heart attacks and related events hit their peak in the early 1960s and has fallen off at about 3% per year since then. Unfortunately, cardiovascular disease is still the number one cause of death, with cancer second. The fall in cardiovas cular mortality can be attributed to two factors: better control of coronary risk factors to prevent disease and better treatment of the disease once found. M ost physicians would agree with the epidemiologic specialists in our schools of public health that it is the former feature, rather than the latter, that is most responsible for this decline. In other words, despite all our technological advances in medical and surgical treatment, it is probably correct to suggest that fewer people are dying from cardiovascular dis ease because fewer people are developing cardiovascular disease in the first place. That is why emphasizing the role of healthy living habits in preventing disease is one of the major purposes of this book. We must also consider, however, those individuals already afflicted. For them, control of risk factors is still impor tant, but so is treatment. What do we know about their prog nosis? When will they develop heart attacks? When will they die? What effect does silent ischemia have on their longevity?
