title: [Civilization stress, cardiovascular risk, evidence-based medicine, guidelines].
abstract: Cardiovascular diseases have the pole-position on the list of morbidity and mortality statistics. Despite the great advances have been made in management of cardiovascular diseases, prevalence of these disorders increases worldwide, and even younger and younger ages are threatened. This phenomenon is strongly related to obesity and type 2 diabetes pandemic, which shows an unequivocal association with expansion of modernized life-style. The pathomechanism proposed to have central role is the chronic stress induced by civilized life-conduct. The authors criticizes the everyday practice suggested for management of cardiovascular diseases, focusing on normalization of cardiovascular risk factors, instead of fighting against the primary cause ie. chronic stress. There is growing evidence, that achieving the target values defined in guide-lines will not necessarily result in improvement of patient related clinical outcomes. The statistical approach generally practiced in randomized clinical trials is primarily striving for the drug-sale, instead of discovering novel pathophysiological relations. Pharmaceutical industry having decisive role in research and patient-care is mainly interested in profit-sharing, therefore patients' interest can not be optimally realized, and costs are unnecessarily augmented. Separation of patient-, and business-oriented medical care is an ethical question of fundamental importance.
authors.affiliation: Siófok Város Kórház-Rendelointézet Siófok Semmelweis u. 1. 8600. kornelsimon@datatrans.hu
authors.forename: Kornél
authors.initials: K
authors.lastname: Simon
mesh_terms: D002317:Cardiovascular Agents / Q000191:economics / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control; D002908:Chronic Disease; D002962:Civilization; D003627:Data Interpretation, Statistical; D003695:Delivery of Health Care / Q000191:economics / Q000941:ethics*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D016527:Drug Costs; D004345:Drug Industry / Q000191:economics / Q000941:ethics; D019317:Evidence-Based Medicine; D014943:Global Health; D017048:Health Care Costs; D006801:Humans; D008019:Life Style; D024821:Metabolic Syndrome / Q000150:complications; D009765:Obesity / Q000150:complications; D010344:Patient Advocacy; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications
chemical_list: D002317:Cardiovascular Agents