Cardiovascular disease: Different strategies for primary and secondary prevention?

European and US guidelines emphasise the importance of identifying and treating all adults with CVD or at high risk for developing CVD. Although tools are available that can aid in the identification and treatment of individuals at risk, substantial opportunities to reduce morbidity and mortality are being missed. If the rising toll of CVD is to be reduced, preventive cardiology for individuals at risk for CHD must become a medical priority. Identification of at-risk individuals and institution of aggressive risk factor modification must become standard practice, in compliance with international treatment guidelines. The complexity of the population screening, the surveillance of those at risk, the requirement to intervene to specific targets, and the need to audit to satisfactory standards will be a considerable challenge to all health providers.