Evidence-based disease management: its role in cardiovascular risk reduction.
Cardiovascular disease remains the most pressing healthcare problem in the United States. Traditional risk factors--hypertension, obesity, and diabetes-are still unresolved issues; and new risk factors--pre-diabetes, insulin resistance, and pediatric and adolescent diabetes-have emerged. There is an urgent need to identify the risk factors for cardiovascular disease, and address risk reduction with disease management and treatment for each factor, based on qualitative and quantitative approaches for developing the evidence base for public health action. The objectives of this paper are to review (i) the burden of cardiovascular illness-morbidity, mortality, and cost; (ii) risk factors and the emerging epidemic of adolescent obesity; (iii) the challenges of attaining target endpoints; and (iv) the attributes of a successful programmatic healthcare initiative for potential impact on cardiovascular care and, eventually, public health.
Fanning
Etta L
EL
Sanofi-Synthelabo, San Antonio, Texas 78232, USA. Etta.Fanning@us.sanofi.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D019468:Disease Management; D019317:Evidence-Based Medicine; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000458:organization & administration; D011379:Prognosis; D011634:Public Health / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D014481:United States