Chapter

Primary Prevention of Coronary Heart Disease

Richard Hobbs

in Cardioprotection

Published on behalf of Oxford University Press

ISBN: 9780199544769
Published online May 2011 | e-ISBN: 9780199607228 | DOI: http://dx.doi.org/10.1093/med/9780199544769.003.0002

Series: Oxford Cardiology Library

Primary Prevention of Coronary Heart Disease

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• Coronary heart disease (CHD) is the leading cause of death and disability in the world • The evidence base for the causes of CHD and for the interventions which reduce CHD risk is huge • Since CHD is multi-factorial, risk factors tend to co-exist in many patients, and are multiplicative in their influence on overall risk, making identifying people at highest risk clinically difficult • CHD risk scores have been developed, based on observed CHD rates amongst well-phenotyped patient cohorts followed up over years. These express absolute risk over a defined period and are the most practical method for determining which people have the most to gain from treatment interventions • Evidence-based interventions include smoking cessation, lifestyle modification in terms of diet and exercise, anti-hypertensives for elevated blood pressure, and ‘statins’ for hyperlipidaemia • Clinical guidelines for CHD prevention provide recommendations on specific targets for blood pressure and lipid-lowering therapy.

Chapter.  3965 words.  Illustrated.

Subjects: Cardiovascular Medicine

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