title: Need for a paradigm shift: the importance of risk factor reduction therapy in treating patients with cardiovascular disease.
abstract: Cardiovascular disease remains the number one killer in the United States, despite advances made in diagnosis and therapy. A major shift to expand treatment beyond symptomatic obstructions and infarctions toward comprehensive therapies aimed at treatment of the underlying disease process could decrease the death rate and cost of cardiovascular disease enormously. In the past 5 years, major trials have clearly demonstrated that aggressive intervention with lipid-lowering therapy can dramatically alter the course of disease. Aspirin, smoking cessation, exercise, diet, and other medical and lifestyle interventions can also decrease risk. Successful therapies are not being implemented, however. Making prevention the primary approach to treatment will require increased resource allocation, use of health provider teams, integration of healthcare delivery systems, and expanded emphasis on educating patients about prevention.
authors.affiliation: Division of Cardiology and the Academic Center for Cardiovascular Disease, University of North Carolina, Chapel Hill 27599-7075, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Smith
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000517:prevention & control* / Q000628:therapy; D018752:Diet, Fat-Restricted; D015444:Exercise; D006801:Humans; D012307:Risk Factors; D016540:Smoking Cessation
chemical_list: D000924:Anticholesteremic Agents