[Primary prevention of cardiovascular diseases. Stepchild of internal medicine].

Preventive medicine has not been adequately established in our health care system. Despite growing in-sight into the causes underlying arteriosclerotic cardiovascular disease, half of the population dies and even more suffer from it. Generally the correction of risk factors is regarded as causal therapy. Modification of the lipid and carbohydrate metabolism or the blood pressure are certainly effective, however, intervention trials have also demonstrated the limitations. Mostly an unhealthy lifestyle underlies these risk factors so that correction of the lifestyle is the causal therapy in the true sense. That is the principle basis for primary prevention, while pharmacotherapy can only be an adjunct. Inadequate nutrition, physical inactivity and smoking are considered the true major risk factors in our society. Changes in nutrition in favor of plant products, some physical activity and refraining from smoking can serve an effective contribution to health. In the future not only medical, but also economic requirements will increasingly force us to establish prevention on the basis of lifestyle changes as a mainstay of medicine.