The clinical and economic significance of atherosclerosis.

The clinical and economic impact of cardiovascular disease is tremendous. Of the four major cardiovascular diseases, coronary artery disease caused by atherosclerosis is the leading cause of death in the United States. It is also a major cause of morbidity. The cost of treating heart disease continues to spiral, from $128 billion in 1994 to an estimated $151 billion in 1996. Studies have shown that treating risk factors for coronary disease--e.g., cigarette smoking, physical inactivity, and elevated low-density-lipoprotein cholesterol and blood-pressure levels--can significantly reduce mortality and improve clinical outcomes. Studies have also shown that risk-factor reduction results in cost savings. Today's challenge is to effectively incorporate risk-reduction strategies into daily clinical practice and reduce the personal and societal burden of cardiovascular disease.