The total care of the arteriosclerotic patient.

The three main risk factors for cardiovascular disease, smoking, hypertension, and hyperlipidaemia, are examined in the light of changing world trends and the mechanisms by which they aggravate this large group of conditions. Prostaglandin activity within the vessel wall and the blood platelets may be disturbed by the risk factors, the control of which in programmes of primary prevention has been followed by striking reductions in cardiovascular morbidity and mortality in two of the world's worst-affected areas. Secondary preventive application of these same measures may improve the outcome in the treatment of established cardiovascular disease in the heart, brain, or limbs. Present advances in combined investigation and multifocal surgical treatment are described against a background of increasing safety throughout the perioperative period.