Reducing the risks of coronary heart disease in individuals and in the population.

Since moderately elevated levels of risk factors for coronary heart disease (CHD) are very common in the UK, a population strategy is the only practicable means of reducing risk in the large numbers of people affected. Even the most effective use of such a strategy is likely to leave a substantial minority of the population at high risk of CHD due to genetic and diet-resistant hyperlipidaemia. Hence the application of a high-risk strategy is equally essential and involves case-finding by widespread use of serum cholesterol measurement, followed by individual medical care. The two strategies are interdependent and additive and should be introduced in parallel to lessen the burden of CHD in the population as a whole and in the very-high-risk minority within the population. There will be a need for more lipid clinics, in addition to the introduction of population measures to combat CHD.