Preventive Approach to Coronary Heart Disease in Physician’s Practice, Hospital Medicine, Occupational Medicine, and Community Health Care

Abstract

Physicians have traditionally been trained for diagnosing diseases and treating patients ‐ people who already are sick. Until now, preventive approach to diseases has not formed any large part of medical practice in most branches of medicine. In the cardiovascular field, despite increasing knowledge concerning possibilities for the prevention of most of the major cardiovascular diseases, practical advances have been slow. The following review will deal with a preventive approach to coronary heart disease (CHD) ‐ a mass health problem which evidently is preventable to a large extent. The background of the prevention of CHD will be briefly summarized. After reviewing the strategies for the prevention of CHD, according to the principles outlined recently by the WHO Expert Committee on the Prevention of Coronary Heart Disease¹, the central elements of a preventive approach to CHD in different settings of health care ‐ in physician’s practice, hospital medicine, occupational medicine, and community health care ‐ will be discussed. A particular emphasis will be given to the role of physicians in the prevention of CHD. The recent Bethesda Conference report on the Prevention of Coronary Heart Disease² is an outstanding and detailed review on this subject focusing especially on the role of physicians. Although the recommendations of the Bethesda Conference are specifically adapted to the circumstances of the United States, most of them are generally applicable.