Tobacco
control, healthier diets are key to cutting heart deaths, four
times more effective than British governmental initiatives
Newswise — Encouraging everyone to
stop smoking and eat healthier is four times more effective at
reducing heart deaths than current government initiatives that
target patients who already have heart problems, finds a study
published online by the BMJ today.
Risk factor reduction should be a
central component of all coronary heart disease (CHD) policies, say
the authors. In the UK and the US, current government policy favours
risk factor reduction in CHD patients (known as secondary
prevention), but risk factor reduction across the whole population
(primary prevention) might be more powerful.
To test their theory, they used a
model to synthesise data for the adult population of England and
Wales, describing numbers of CHD patients, uptake of treatments, and
the effect of reducing three major risk factors (smoking,
cholesterol, and blood pressure) in people with and without CHD.
Between 1981 and 2000, CHD death
rates fell by 54%, resulting in 68,230 fewer deaths in 2000.
Approximately half of this fall
(45,370 fewer deaths) was attributable to reductions in smoking,
cholesterol, and blood pressure in the whole population. However,
primary prevention had a fourfold bigger impact on mortality than
secondary prevention, with 81% (36,625) fewer deaths in people
without recognised CHD and 19% (8,745) fewer deaths in CHD patients.
Primary prevention clearly
achieved a larger reduction in deaths, compared with secondary
prevention, say the authors. Comprehensive CHD strategies should
therefore focus on population-wide tobacco control and healthier
diets, they conclude.