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March 28, 2007

Primary Prevention of Atherosclerotic Cardiovascular DiseaseThe High Public Burden of Low Individual Risk

JAMA. 2007;297(12):1376-1378. doi:10.1001/jama.297.12.1376

Physicians and many laypeople are well aware of the substantial risks posed by asymptomatic atherosclerosis.1 Among 50-year-old adults enrolled in the Framingham Heart Study, the lifetime risk for developing symptomatic disease was 52% in men and 39% in women.2 For many patients the first clinical manifestation is a potentially catastrophic event, such as stroke, myocardial infarction, or sudden death.1 Despite numerous advances in the understanding of the epidemiology and prevention of clinical atherosclerosis, the public disease burden remains high and may, with the current obesity epidemic, be increasing.3 Primary prevention, that is preventing or delaying clinical disease among asymptomatic individuals, therefore remains an issue of major public health interest.

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