title: The promise and practice of cardiovascular risk reduction: a disease management perspective. Clinical Quality Improvement Network (CQIN) Investigators.
abstract: OBJECTIVE
  Interpretive analysis of epidemiological, clinical trials and practice pattern data for cardiovascular risk reduction in the contemporary setting of unprecedented demographic changes.
  
  
  METHODS
  Literature review and audit results of the Clinical Quality Improvement Network (CQIN).
  
  
  RESULTS
  Coronary artery disease (CAD) is the largest single cause of death in Canada. CAD is age-related and the population is rapidly ageing, a combination that threatens an epidemic of future CAD events. Epidemiological data demonstrate a direct relation of CAD risk and serum cholesterol levels and no threshold cholesterol level below which there is no CAD risk. The epidemiological data also suggest CAD risk can be reduced by lowering serum cholesterol and this hypothesis has now been incontrovertibly confirmed by repeated randomized clinical trials. Most recently, reduction of all-cause mortality with cholesterol-lowering therapy in high risk subjects has also been confirmed. Despite the overwhelming trials and epidemiological evidence, CQIN effectiveness analyses reveal far from optimal risk assessment and management practices among high risk patients.
  
  
  CONCLUSIONS
  Serum cholesterol is directly related to CAD risk. Reduction of cholesterol reduces CAD, and all-cause, mortality in high risk patients. There is a large window of opportunity to improve lipid-lowering practices, and patient outcomes, for the most deadly diseases in our society.
authors.affiliation: Epidemiology Coordinating and Research Centre, University of Alberta, Montreal, Quebec.
authors.forename: T
authors.initials: T
authors.lastname: Montague
authors.forename: P
authors.initials: P
authors.lastname: Montague
authors.forename: V
authors.initials: V
authors.lastname: Dzavik
authors.forename: K
authors.initials: K
authors.lastname: Teo
mesh_terms: D002170:Canada / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D012307:Risk Factors
chemical_list: D002784:Cholesterol