Put disease prevention first

Worldwide, non-communicable diseases are the dominant cause of death, with atherosclerotic cardiovascular disease (CVD) a major contributor. These deaths are spread across high- to low-income countries, with about one in three of all CVD deaths occurring in under 70 year-olds, amounting to an estimated six million cases annually. Analyses in many countries have shown that both an improvement in risk factors and advances in medical therapies have contributed to the fall in age-standardised mortality from coronary heart disease (CHD). Importantly, leading a healthy lifestyle has broader implications for the prevention and management of other non-communicable diseases including cancer, diabetes and chronic respiratory diseases. Following decades of major advances in the treatment of acute CHD events it is being appreciated increasingly that evidence-based long-term management of CHD is critical to achieve optimal reductions in mortality and morbidity. Each year, approximately 50 percent of major coronary events occur in those with a hospital discharge diagnosis of CHD. Half of these recurrent events are fatal. A significant number of such CHD events will occur within the first year after hospitalization for non-fatal acute coronary syndromes.