Prevention Of Myocardial Infarction

Coronary heart disease remains the leading cause of death in both men and women in most industrialized countries. Yet it is largely preventable, and health care providers can acquire the skills to help their patients reduce their risks substantially. Traditional risk factors such as cigarette smoking, hypercholesterolimia, hypertension, sedentary lifestyle, obesity and glucose intolerance explain a major proportion of coronary events. Recent evidence also suggests important adjunctive roles for hormone replacement therapy in postmenopausal women, and aspirin prophlaxis in individuals at high risk of a first myocardial infarction. Emerging evidence indicates an important role for diet in the prevention of heart disease. Although the importance of lifestyle and behavioral modifications may well be known among physicians and other health-care providers, the implementation of this knowledge has been limited. One reason is that the information supporting the value, feasibility and cost-effectiveness of risk-reduction strategies has not been previously synthesized and made widely available to health-care providers in office and community settings. Prevention of Myocardial Infarction fills these critical gaps by providing a state-of-the-art compendium of the scientific evidence on the efficacy of coronary disease prevention, while focusing on helping clinicians develop intervention skills to utilize available knowledge. Chapters by leading authorities in cardiovascular epidemiology, clinical cardiology, cost-effectiveness analysis, and public health translate the theory of preventive cardiology into feasible implementation. The counseling and other intervention strategies described in this textbook have documented clinical efficacy and cost-effectiveness, and they require little time to learn or implement. The book is written mainly for primary care providers, including general internists and family physicians, but will also be of interest to medical subspecialties such as cardiologists and endocrinologists, as well as medical students, dietitians, psychologists, epidemiologists, and students, practitioners, and researchers in public health.

Despite considerable effort in primary prevention, coronary heart disease continues to be the leading cause of death in the industrialized nations. The patient who survives his first myocardial infarction carries approximately a tenfold risk of recurrence and sudden death when compared to the normal population. The concept of secondary prevention, therefore, has emerged as an active strategy aimed at the reduction of fatal and non-fatal recurrences of myocardial infarction. Apart from risk factors of relevance in primary prevention, secondary prevention is dependent on the extent of the disease itself; in other words the number of vessels involved, the extent of myocar dial damage and the degree of electrical instability. Nonmedical aspects such as the level of education, the degree of social support and the attitude towards stress also appear to influence the prognosis. The aim of this volume is to bring together all those factors relevant to achieving the maximal life span in patients afflicted with a disease that by its very nature is a lifelong process. However, as the late Paul Dudley White stated appropriately more than 40 years ago, it is not sufficient merely to add years to a life, one should also add life to the years. This concept truly is the nucleus of secondary prevention, sine only a life worth living generates the motivitation needed to take all the steps necessary in secondary pre vention. The authors and the editor are most grateful to Pharma Schwarz Inc.

With the numerous advances that have been made in treatment of heart disease over the past 20 years, physicians are now emphasizing more than ever the prevention of heart disease. This issue provides cardiologists with practical state-of-the-art information on prevention that can be be easily applied to their patients. Topics covered include diabetes, lipid-lowering therapy, RAAS blockade, emerging therapies for atherosclerosis prevention, and heart disease in women.

"EACPR, European Association for Cardiovascular Prevention and Rehabilitation -- European Society of Cardiology."

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.

Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data--including population surveys, cohort studies, disease registries, administrative health data, and vital statistics--contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.

The aim of this textbook is to give guidance in prevention, lifestyle counselling and rehabilitation for cardiologists, other physicians and many different categories of health professionals in cardiac rehabilitation teams.