A call to action.

Abstract

Acute myocardial infarction remains the principal cause of death in people aged over 40 years, despite the reductions in coronary heart disease (CHD) mortality that have been observed over the past 25 years in many European countries. Consequently, there is considerable potential to decrease further the risk of cardiovascular morbidity and mortality. This can be achieved through effective lifestyle interventions and appropriate control of blood pressure and blood lipid profiles. Such a multifactorial approach to treatment is warranted because of the complex, and often synergistic relationships between independent risk factors, such as smoking and lipid levels. Guidelines have been introduced to facilitate the application of effective primary and secondary CHD prevention programmes that target multiple risk factors, according to the risk factor profile of the individual. However, it is apparent from recent surveys that physicians have been slow to adopt and implement these guidelines in clinical practice. The extent to which serum cholesterol concentrations are routinely measured is especially poor, and even when hypercholesterolaemia is identified it is frequently undertreated. Since effective lipid-lowering agents are now available and should provide substantial benefits in terms of CHD risk reductions, physicians are urged to consider lipid-lowering therapy as an essential component of both primary and secondary CHD prevention programmes.