Notes from the journals

between 1981 and 2000 Unal B, Critchley JA, Capewell S Circulation 2004; 109: 1101-1107. Coronary heart disease mortality rates have been decreasing in the UK since the 1970s. The study examined how much of the decrease in England and Wales between 1981 and 2000 could be attributed to medical and surgical treatments and how much to changes in cardiovascular risk factors. The main data sources were published trials and meta-analyses, official statistics, clinical audits, and national surveys. Between 1981 and 2000, coronary heart disease mortality rates in England and Wales decreased by 62% in men and 45% in women 25-84 years old. This resulted in 68, 230 fewer deaths in 2000. More than half the coronary heart disease mortality decrease in Britain between 1981 and 2000 was attributable to reductions in major risk factors, principally smoking. This emphasises the importance of a comprehensive strategy that promotes primary prevention, particularly for tobacco and diet, and that maximises population coverage of effective treatments, especially for secondary prevention and heart failure. STAR PAPER Literature review