Primordial prevention of cardiovascular disease risk in The Netherlands.

Developments about cardiovascular disease (CVD) risk factors in The Netherlands since the 1970s are described in relation to health policy. The prevalence of hypercholesterolemia, hypertension, and obesity changed little in the 1970s and 1980s. In recent years, however, the prevalence of hypercholesterolemia tended to decrease and that of obesity to increase. The prevalence of hypertension remained stable but the percentage of treated hypertensives declined since 1987. Between 1958 and 1993 the percentage of male smokers decreased from 90% to about 40%. In women the percentage of smokers decreased from about 40% in 1975 to about 30% in 1993. Between 1987 and 1992 the intake of saturated fat decreased from 16.5 to 14.1% of energy. But during that period the intake of vegetables also decreased from 144 to 128 g/day and that of fruits from 125 to 114 g/day. Recent surveys show that up to age 65, approximately 25% of the Dutch population is physically inactive. This percentage increases sharply after age 65. Health policy for primordial prevention of CVD in The Netherlands is aimed at reduction of smoking prevalence, improvement of dietary habits, and promotion of physical activity.