Communicating risk—coronary risk scores

Summary. Cardiovascular disease, particularly heart attack and stroke, is the major cause of death in adults in Europe. The underlying atherosclerosis which causes cardiovascular disease is difficult to treat or reverse, and this has led to intense interest in strategies to prevent its development. The major causes of cardiovascular disease—a high fat diet, tobacco smoking and high blood pressure—are now well known. Control of these risk factors has been shown to reduce the risk of heart attack or stroke. It is now possible with simple information (age, sex, blood pressure level, cholesterol level and information on smoking) to predict the risk of heart attack or stroke fairly accurately. The challenge for the future is to make the information available on risk prediction and on how to reduce risk accessible to lay people, so that they may choose, if they wish, to adopt a life style that will reduce their risk. Such a life style involves healthy food choices, avoidance of overweight, the promotion of leisure exercise and complete avoidance of tobacco. Drug treatments can be extremely effective in controlling both blood pressure and cholesterol levels, but they should be seen as an adjunct to life style measures rather than a primary means of achieving prevention. Practical prevention will only be achieved through dynamic partnerships between the medical profession, Government, voluntary bodies, teaching institutions, insurance companies and paramedical bodies. An outline about how cardiac societies can participate in this process is appended.