Cardiovascular disease prevention: talking occurs at all levels--does understanding?

The magnitude of the health problems posed by cardiovascular disease is well known and represents a major public health challenge. Traditionally programmes of prevention have had a 'lifestyle' orientation, focusing on individual behaviours. Ironically, it may well be that profound societal changes, notably the agricultural and industrial revolutions, have largely been responsible in the most fundamental sense for the modern epidemic of cardiovascular disease. Thus attempts to deal with individually expressed behaviours alone may not be the most effective way to prevent the development of cardiovascular disease in our society. Ultimately, it will be the creation of social environments in which healthy behaviours are the norm that will have the most profound effect on the community's cardiovascular health. Misunderstandings abound. Politicians, while speaking favourably about the importance of prevention, do not match their rhetoric with resources. Many health professionals mistake 'risk-factor identification' with 'prevention'. Private industry has often confused or distorted public understanding in the process of marketing products deemed to have cardiovascular benefits. The public's awareness of many of the basic epidemiological realities concerning the prevention of cardiovascular disease is often sadly lacking. In spite of the misunderstandings, preventive approaches have played a significant role in the reduction of cardiovascular disease, a role that should become more prominent in the future.