The Pharmaceutical Journal
Vol 275 No 7363 p218
20 August 2005

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Focus should be on primary prevention in heart disease

Public health initiatives that support the primary prevention of coronary heart disease (CHD) avoid four times as many deaths as initiatives targeted at patients who already have heart disease, according to a new study.

Researchers used a model to analyse the decrease in CHD mortality in England and Wales between 1981 and 2000. During this period CHD death rates fell by 54 per cent, resulting in an estimated 68,230 fewer deaths.

The researchers calculate that about half of the avoided deaths could be attributed to primary prevention: reductions in smoking, cholesterol and blood pressure in people without recognised CHD. Furthermore, primary prevention had a greater impact than secondary prevention: the researchers estimate that there were 36,625 fewer deaths in people without recognised CHD and 8,745 fewer deaths in CHD patients.

“Comprehensive CHD strategies should therefore focus on primary prevention, particularly tobacco control and healthier diets,” the researchers conclude. The study is published on BMJ Online First