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Can We Prevent Heart Disease?

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These studies have been conducted by Drs. G. Tibblin, L. Wilhelmsen, B. Lindholm, A. Gustafsson, J. Fodor, and Dr. Elmfelt in a concentrated effort to analyze the natural history of ischemic heart disease. The general approach was partly initiated by the European office of WHO, Copenhagen, whose chief officer in the cardiovascular branch, Z. Pisa, has been most helpful. Financial support has been received from the Swedish Association against Lung and Heart Disease, Förenade Liv, and the Swedish Margarine Producer's Association for Nutritional Studies, Stockholm, Sweden, and from WHO. The preventive trial is conducted with aid from The Bank of Sweden Tercentenary Fund.

▸Requests for reprints should be addressed to Lars Werkö, M.D., Med. Dept. I, Sahlgren's Hospital, 413 45 Göteborg, Sweden.

Ann Intern Med. 1971;74(2):278-288. doi:10.7326/0003-4819-74-2-278
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Prevention of heart disease is critically reviewed. Although several risk factors have been identified that seem to characterize individuals most prone to later development of ischemic heart disease, no one has been able to show that interfering with these risk factors will decrease the incidence of the disease. A current population study indicates that removal of only one risk factor may have little or no impact on the overall morbidity or mortality in middle-aged men in Western societies. A multifactorial approach seems necessary to influence a disease that, like ischemic heart disease, is influenced by many environmental factors. The hypothesis that removal of several risk factors will decrease the incidence of ischemic heart disease in the community must be tested before any large-scale changes are advocated in our life style. Such a study is described. Changing social structure in the community, however, may be of larger importance for the prevention of ischemic heart disease than any medical intervention.





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