title: Population-level changes to promote cardiovascular health.
abstract: BACKGROUND
  Cardiovascular diseases (CVD) cause 1.8 million premature (<75 years) death annually in Europe. The majority of these deaths are preventable with the most efficient and cost-effective approach being on the population level. The aim of this position paper is to assist authorities in selecting the most adequate management strategies to prevent CVD.
  
  
  METHODS
  Experts reviewed and summarized the published evidence on the major modifiable CVD risk factors: food, physical inactivity, smoking, and alcohol. Population-based preventive strategies focus on fiscal measures (e.g. taxation), national and regional policies (e.g. smoke-free legislation), and environmental changes (e.g. availability of alcohol).
  
  
  RESULTS
  Food is a complex area, but several strategies can be effective in increasing fruit and vegetables and lowering intake of salt, saturated fat, trans-fats, and free sugars. Tobacco and alcohol can be regulated mainly by fiscal measures and national policies, but local availability also plays a role. Changes in national policies and the built environment will integrate physical activity into daily life.
  
  
  CONCLUSIONS
  Societal changes and commercial influences have led to the present unhealthy environment, in which default option in life style increases CVD risk. A challenge for both central and local authorities is, therefore, to ensure healthier defaults. This position paper summarizes the evidence and recommends a number of structural strategies at international, national, and regional levels that in combination can substantially reduce CVD.
authors.affiliation: Research Centre for Prevention and Health, Capital Region of Denmark, Denmark. torjor01@regionh.dk
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.forename: Steven
authors.initials: S
authors.lastname: Allender
authors.forename: Susana
authors.initials: S
authors.lastname: Sans
authors.forename: Tomasz
authors.initials: T
authors.lastname: Zdrojewski
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.forename: Johan
authors.initials: J
authors.lastname: de Sutter
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.forename: Susanne
authors.initials: S
authors.lastname: Løgstrup
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
authors.forename: Sofie
authors.initials: S
authors.lastname: Malyutina
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Reiner
authors.forename: Grethe S
authors.initials: GS
authors.lastname: Tell
authors.forename: W M Monique
authors.initials: WM
authors.lastname: Verschuren
authors.forename: Diego
authors.initials: D
authors.lastname: Vanuzzo
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006291:Health Policy; D006293:Health Promotion / Q000331:legislation & jurisprudence*; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior