Deaths from heart disease reduced by preventive drugs

More than 50 percent of deaths and disability from heart disease and strokes, which together kill more than 12 million people worldwide each year, can be halved. It can be done by a combination of simple, cost effective national efforts and individual actions to reduce major risk factors such as high blood pressure, high cholesterol, obesity, smoking, preventive drugs and aspirin as reported recently by the World Health Organization (WHO). These findings come from the first-ever global analysis of disease burden due to major cardiovascular risk factors. They are contained in the upcoming WHO Report 2002. One major finding of the report is that blood pressure alone causes about 50 percent of heart disease worldwide. Cholesterol causes about one-third. Inactive lifestyles, tobacco use and low fruit and vegetable intake account for 20 percent each. The most immediate improvements in cardiovascular health can be achieved with a combination of drugs – statins for cholesterol lowering and low-doses of common blood pressure lowering drugs and aspirin - given daily to people at elevated risk of heart attack and stroke. This highly effective combination therapy could be much more widely used in the industrialized world, and is increasingly affordable in the developing world. This drug combination could cut death and disability rates from heart disease by more than 50 percent among people at risk of cardiovascular disease. This report also urges countries to adopt policies and programmes to promote population-wide interventions like reducing salt in processed foods, cutting dietary fat, encouraging exercise and higher consumption of fruits and vegetables and lowering smoking. Most of the benefits from these combined interventions can be achieved within five years of their implementation. If no action is taken to improve cardiovascular health and current trends continue, WHO estimates that 25 per cent more healthy life years will be lost to cardiovascular disease globally by 2020. The brunt of this increase will be borne by developing countries. Prevention is the key to lowering the global disease burden of heart attacks and strokes. The ideal strategy for many countries would be to devote more resources to introduce broad measures that can benefit the whole population and at the same time target those at elevated risk with the combination of drugs.