ABSTRACT
In the United States and other affluent industrialized countries, Coronary Artery Disease (CAD) is the leading cause of death and a major cause of morbidity. The costs of CAD in medical care, hospitalization, physician's charges, medications, and lost output due to disability - will be some $72. The technological imperative has produced more costly interventions in the "curative" approach to CAD. Management consists largely of monitoring, drug treatment of arrhythmias, vasodilator drugs, beta-blockers, now slow calcium channel blockers, thrombolytic therapy, percutaneous transluminal coronary angioplasty. If these measures fail to relieve signs or symptoms of CAD, patients are sent for cardiac angiography and frequently to the operating room for coronary artery bypass surgery. Recognition of the modifiable risk factors for CAD comes largely from epidemiologic studies. The modifiable risk factors, which are so prevalent in human affluent society, are responsible for the majority of instances of CAD. Today most health insurance plans specifically proscribe reimbursement for health promotion activities.
