ABSTRACT
The strong relationship between a small number of modifiable risk factors and cardiovascular disease (CVD) and the availability of cost-effective interventions to prevent and treat CVD highlight the large potential to reduce mortality and morbidity from CVD. Primary prevention relies on interventions in multiple sectors designed to promote healthy behaviours in the whole population (e.g. improve healthy diets, reduce exposure to tobacco, increase levels of physical activity) and to improve the environment (e.g. reduce air pollution). At the individual level, counselling to encourage the adoption of healthy behaviours, medical treatment to reduce risk factors (e.g. hypertension, dyslipidaemia, diabetes) and reducing the risk of individuals with established CVD (e.g. low-dose antiplatelet therapy)are cost-effective and much of it can be delivered in primary care. The importance of the total risk approach (e.g. CVD risk scores) is described. The need for political action to tackle CVD is highlighted: health systems need to be adequately resourced to deliver effective care and many interventions to prevent CVD require action beyond the health sector. The main interventions (with emphasis on the WHO ‘best buys’) to prevent and treat CVD are described.
