Chapter 1: Introduction

K CVD is the major cause of premature death in most European populations. It is also a major cause of disability and contributes substantially to the escalating costs of healthcare. K The underlying atherosclerosis develops insidiously over many years and is usually advanced and difficult to reverse by the time that symptoms occur. K Death, myocardial infarction and stroke frequently occur suddenly and before medical help is available. It follows that many therapeutic interventions are either inapplicable (if death occurs suddenly) or palliative. K The mass occurrence of CVD relates strongly to modifiable lifestyle and pathophysiological factors. K CVD is rare in countries where population risk factor levels remain low through adult life. K Risk factor modifications have been unequivocally shown to reduce mortality and morbidity, particularly in high risk patients.