In 1995, the latest year for which statistics are available, heart disease, cancer, and stroke continued to be the three leading causes of death in the United States. Notably, however, a wealth of experience has confirmed that hygienic interventions such as diet, exercise, weight loss, and smoking cessation can reduce the toll from heart disease while also reducing the morbidity and mortality associated with stroke and cancer. This chapter will describe the rationale for the primary prevention of coronary heart disease (CHD), review the basic concepts involved in cholesterol screening, and update the reader regarding key preventive measures, such as diet, exercise, and smoking cessation. Also highlighted will be recent clinical trial results suggesting the benefits of lipid-lowering drugs in "high-risk" individuals who have not experienced a coronary event. These findings represent an exciting advance that emphasizes the value of preventive efforts in curbing CHD.
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