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British Medical Bulletin 59:3-16 (2001)
© 2001 Oxford University Press

Asymptomatic individuals – risk stratification in the prevention of coronary heart disease

David Wood

Department of Cardiology, Charing Cross Hospital, London, UK

The report of the World Health Organization Expert Committee on Prevention of Coronary Heart Disease considered that a comprehensive action for coronary heart disease (CHD) prevention has to include three components:

  1. A population strategy – for altering, in the entire population, those life-style and environmental factors, and their social and economic determinants, that are the underlying causes of the mass occurrence of coronary heart disease
  2. A high risk strategy – identification of high risk individuals, and action to reduce their risk factor levels
  3. Prevention of recurrent coronary heart disease events and progression of the disease in patients with clinically established coronary heart disease1.

Prevention targeted at patients with established coronary disease and the high risk strategy targeted at healthy individuals at high risk are an integral part of clinical practice. The clinical approaches and the population approaches for coronary heart disease prevention are complimentary, but the population strategy is fundamental to reducing the burden of cardiovascular disease.


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