title: Strategy of reducing coronary risk and the use of drugs.
abstract: The strategy of primary prevention of coronary heart disease (CHD) needs reconsideration. Recent results of trials of reducing the risk of CHD in those at moderate risk have been inconclusive and disappointing. More may be expected from intervention in those at high risk, and a selective policy is advocated. But, in those at high risk, it is usually necessary to give drugs in order to reduce the risk from hypertension and hypercholesterolaemia. Many currently used and popular drugs have never been submitted to rigourous long-term testing of their safety, although it was only through formal clinical trials that the adverse effects of clofibrate and of thiazides were identified. More, not fewer, clinical trials are needed if we are to avoid new tragedies. A plea is made for the urgent establishment of drug data banks to permit accurate monitoring of changes in the incidence of commonly occurring diseases in relation to the increasing use of drugs for primary prevention of vascular diseases and for social convenience.
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D002994:Clofibrate / Q000627:therapeutic use; D003327:Coronary Disease / Q000517:prevention & control*; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications; D007256:Information Systems; D008055:Lipids / Q000097:blood; D012306:Risk; D013927:Thrombosis / Q000517:prevention & control
chemical_list: D000319:Adrenergic beta-Antagonists; D002317:Cardiovascular Agents; D004232:Diuretics; D008055:Lipids; D002784:Cholesterol; D002994:Clofibrate