Coronary heart disease: Epidemiology and prevention

Coronary heart disease (CHD) is now the leading cause of death and disability globally. Despite recent declines in age-adjusted death rates from CHD, the number of CHD deaths have been increasing due to a combination of growth in population numbers and their longevity. In addition, manifestation and outcome of CHD varies substantially between and within countries. Unlike many other common medical conditions that disable and kill and remain unpreventable, CHD is to a large extent preventable. There are strong, unconfounded relationships between several risk factors and CHD mortality and non-fatal myocardial infarction. The most important risk factors for CHD are smoking, high blood pressure, dyslipidaemia, diabetes, physical inactivity, unhealthy diet, and obesity. Controlling these risk factors, even in middle-aged individuals, through lifestyle changes, medical treatment, or public health interventions, may reduce CHD incidence by almost one-half.