[Strategies in the control of coronary risk factors in primary and secondary prevention].
The longitudinal observational studies began in 1948, have permitted to identify the coronary risk factors that is, the biological signs and lifestyles more frequent in the future coronary patients than in the entire cohort. The long follow-up of these studies has cooperate in the identification of other important risk factors and their role in middle aged women and in both genders older than 65 years. There are two strategies in the primary prevention, one directed to community and the other to the high risk group. As a consequence of the progress in the identification of the high risk candidates, the primary prevention of the high risk groups become similar to the strategy in the secondary prevention of the coronary patients. The advances in the reduction of the mortality and morbidity by the main risk factors control observed in the last years, increase the need of a more energetic approach to the high risk groups in the primary and secondary prevention. The differences in the coronary mortality between countries suggest the adoption of acceptable priorities for the primary prevention of coronary heart disease in each country. My recommendations for Spain are: a) To discourage boys and adolescents from beginning cigarette smoking; b) To avoid that cigarette smoking becomes a sign of autoaffirmation for young women; c) To include the education for a balanced food intake in the school programs, d) To get that non competitive sport could be accessible and desirable for the youth after the end of education period, and e) To create the adequate conditions for the identification and control of the high risk group in primary care centers.
Departamento de Cardiología, Hospital Santa Creu i Sant Pau, Barcelona.
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Balaguer Vintró
D000367:Age Factors; D003324:Coronary Artery Disease / Q000517:prevention & control; D003327:Coronary Disease / Q000517:prevention & control*; D005260:Female; D006266:Health Education; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D000074606:Smoking Prevention