The remarkable decline in mortality from cardiovascular disease (CVD) in the United States since the 1960s has been attributed to a combination of primary prevention measures (smoking cessation, healthful diet, increased exercise), management of elevated blood pressure and lipids, and treatment of CVD when it occurs (revascularization, heart failure drugs). But since 2016, CVD death rates have leveled off and may even be rising slightly, prompting consideration of the next phase of how to address CVD. Currently, prevention options are to advocate broadly for primary prevention and to test for conventional risk factors and assign an estimated risk as the basis for treatment (secondary prevention).
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Joyner MJ, Paneth N. Cardiovascular Disease Prevention at a Crossroads: Precision Medicine or Polypill? JAMA. 2019;322(23):2281–2282. doi:10.1001/jama.2019.19026
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