Primary and secondary prevention of coronary artery disease
THE CONTEXT
Prevention of coronary artery disease (CAD) includes interventions before a clinical event and treatment aimed at preventing further events.
Primary and secondary prevention
•
Primary prevention uses lifestyle changes or therapeutic interventions to prevent CAD and other forms of atherosclerosis in the whole population or in healthy individuals at elevated risk.
•
Secondary prevention initiates treatment in patients who have already had an event to reduce the risk of subsequent events.
•
The distinction is increasingly considered arbitrary because many people have CAD without symptoms or previous clinical events.
Population-based primary prevention
•
The population-based strategy aims to modify risk factors throughout the population through diet and lifestyle advice.
•
Even small reductions in smoking or average cholesterol, or changes in exercise and diet, can produce worthwhile benefits.
•
Obesity and smoking also increase the risk of other diseases and should be actively discouraged through public health measures.