[e-drug] WHO on prevention of heart disease

[Valeria Frighi <valeria.frighi@dtu.ox.ac.uk>]

E-drug: WHO on prevention of heart disease
---------------------------------------------
Copied as fair use

Valeria Frighi

BMJ 2002;325:853 ( 19 October )

News

WHO warns of heart disease threat to
developing world

Zosia Kmietowicz, London

The number of people who die or are disabled by heart disease and
strokes could be halved with wider use of a combination of drugs that 
costs just
$14 (�9.14) a year, the World Health Organization has said.

Every year 12 million people worldwide die from cardiovascular disease,
according to the WHO, with most of them in the developing world. The
organisation will be focusing on heart disease when it publishes its
annual report at the end of the month.

The report shows for the first time that the main risk factors for
cardiovascular disease, high blood pressure, high cholesterol
level, and smoking, which are traditionally linked to an affluent
lifestyle, are now being seen in middle income and poorer
countries.

But if everyone at high risk of having a heart attack or stroke was
given a combination of a statin for lowering cholesterol, a low
dose blood pressure lowering drug, and aspirin then this number could be
cut by 50%.  More people in the developed world should be given this 
treatment, says the report, while new resources should be found to 
treat people in countries where the combination is unaffordable.

The WHO also calls for more measures to reduce cardiovascular risk in
the population as a whole. It argues that there is increasing 
evidence to show that it is not just people whose blood pressure or 
cholesterol level is above a given "threshold" who are at risk of 
cardiovascular disease. In fact, most people would benefit from 
lowering their blood pressure and cholesterol
level, and national education programmes should tackle these issues.

"Prevention is the key to lowering the global disease burden of heart
attacks and strokes," says Dr Gro Harlem Brundtland, director general 
of the WHO. "The ideal strategy for many countries would be to devote 
many more resources to introduce broad measures that can benefit 
whole populations and at the same time target those at elevated risk 
with the combination of pills."

The report highlights how government campaigns have led to less salt 
being used in manufactured foods in the United Kingdom, better blood 
pressure management in Japan, and a fall in saturated fat intake in 
the United States.

"If we consider the dramatic improvement in cardiovascular health 
that, for example, the Japanese and the Finns have experienced in the 
last few decades, we can see that entire populations have been able 
to significantly improve their situations without any change in their 
gene pool," said Dr Christopher Murray,
executive director of the cluster on evidence and information policy 
at the WHO.

"Clearly diet, exercise, and a reduction in tobacco and alcohol are the
most important factors to consider," he added.

Footnotes

World Health Report 2002: Reducing Risks, Promoting Healthy Life will be
accessible from the end of October on
www.who.int/whr
-- 
Dr. Valeria Frighi
Diabetes Trials Unit
Radcliffe Infirmary
Woodstock Road
Oxford OX2 6HE
UK
tel. -44-1865-228422
fax -44-1865-224584
e-mail valeria.frighi@dtu.ox.ac.uk
--
To send a message to E-Drug, write to: e-drug@usa.healthnet.org
To subscribe or unsubscribe, write to: majordomo@usa.healthnet.org
in the body of the message type: subscribe e-drug OR unsubscribe e-drug
To contact a person, send a message to: e-drug-help@usa.healthnet.org
Information and archives: http://www.healthnet.org/programs/edrug.html