WHEREAS, cardiovascular disease, including stroke, and peripheral vascular disease are the leading causes of morbidity and mortality in the United States and in many other countries, and

WHEREAS, there has been a very substantial decline in coronary heart disease and stroke mortality over time, and

WHEREAS, this decline, however, has slowed in recent years and for stroke there may actually be a slight increase in mortality rates, and

WHEREAS, cardiovascular disease accounts for the largest proportion of the substantial difference in mortality between blacks and whites in the United States and recent studies have shown that the incidence of coronary heart disease is rising in American Indian populations (The Strong Heart Study) and probably is similar at least among Mexican Americans and U.S. whites (The Corpus Christi Study), and

WHEREAS, in 1998 there was 204,000 deaths in the United States from acute myocardial infarction; 256,000 deaths from coronary heart disease; 158,000 deaths due to stroke; 43,000 due to other atherosclerosis; and, 279,000 from other cardiovascular diseases (Total of 940,000 cardiovascular deaths). (Fact Book, Fiscal Year 2000, NHLBI), and

WHEREAS, heart disease accounts for approximately 30% of all deaths among blacks, Hispanics, Asians, and American Indians, and stroke for 5-10% of all deaths, and

WHEREAS, we have previously shown that the primary risk factors for cardiovascular disease are similar among racial, ethnic, and sex groups in the United States, i.e., level of total cholesterol, LDLc, triglycerides and HDLc, blood pressure, cigarette smoking, and diabetes mellitus, and

WHEREAS, Dr. Jeremiah Stamler, using data from the Multiple Risk Factor Intervention Trial (MRFIT), and data from two industrial studies in Chicago, demonstrated that populations in the United States with very low risks of coronary heart disease can be identified based simply on the measures of serum cholesterol<200 mg%, non-cigarette smoking, systolic blood pressure <120, and no history of diabetes, and

WHEREAS, a recent report from the Nurses Study has demonstrated that a combination of lifestyles and risk factors identified women with extremely low risk of coronary heart disease and both of these studies, however, demonstrated that only a very small percentage, perhaps <20% of the U.S. population is in this low risk category, and

WHEREAS, rising health care cost in the United States, especially to the Medicare Program are primarily related to the staggering cost of the treatment of cardiovascular disease, and

WHEREAS, coronary heart disease and stroke are primarily preventable diseases and the prevention of the rise in risk factors and elevated risk factors in the population is by far the best approach for reducing the risk of cardiovascular disease in the population, and

WHEREAS, at the present time, no more than one-third or so of hypertensives have their blood pressure controlled with effective drug therapy. Better treatment of hypertension would substantially reduce morbidity and mortality due to stroke, cardiovascular disease, congestive heart failure and renal disease, and would especially have a major impact on poorer and minority populations which have an excess burden of hypertensive related diseases, and

WHEREAS, new therapies are available for successfully reducing elevated risk factors for those individuals in the population whose risk factors cannot be modified by various lifestyle approaches, such as diet, exercise, etc., and

WHEREAS, it is now possible to identify individuals at very high risk prior to a heart attack by non-invasively measuring the extent of atherosclerosis and the progression of atherosclerosis, and

WHEREAS, the American College of Preventive Medicine should take a leading role in the development of a national program to substantially reduce the risk factor levels, i.e., cholesterol, blood pressure, cigarette smoking, and prevalence of diabetes, among the U.S. population, and

WHEREAS, the American College of Preventive Medicine should make sure that every American who is at high risk of cardiovascular disease based on their risk factor levels, and needs either pharmacological or non-pharmacological therapy receives such treatment to prevent the development of clinical coronary artery disease, and

WHEREAS, the American College of Preventive Medicine should insure that all individuals who are at very high risk of coronary heart disease or stroke are adequately treated and followed in the community to reduce their risk of heart disease,

BE IT RESOLVED,

THAT: The American College of Preventive Medicine work with the Center for Disease Control and State Health Departments to establish a strong program in cardiovascular disease prevention including the training of public health leaders in the effective development of public health and preventive medicine programs to reduce cardiovascular risk factors.

THAT: The American College of Preventive Medicine encourage programs in preventive medicine at professional health training institutions such as medical schools, nursing schools, schools of public health be encouraged to develop strong curriculum and outreach programs to reduce cardiovascular risk factors and the incidence of coronary heart disease and stroke in the community.

THAT: The American College of Preventive Medicine should encourage improved training of dietitians, nutritionists and behavioral experts in nutritional interventions to prevent the rise in LDLc levels of reduce levels of LDLc level in the population.

THAT: The American College of Preventive Medicine should work closely and develop a dialog with food manufacturers and with advertising agencies in the United States to encourage a further substantial reduction in the amount of saturated fat and cholesterol in the American diet, and a decrease in the amount of sodium.

THAT: The American College of Preventive Medicine work with federal and state health departments and the health schools to substantially improve the treatment and control of elevated blood pressure in the United States.

THAT: The American College of Preventive Medicine continues to make a major effort to encourage the use of the funds from the settlement with the tobacco companies to be used for programs to further substantially reduce the amount of cigarette smoking in this country and especially to prevent cigarette smoking among children.

THAT: The American College of Preventive Medicine should reinforce to the public that cardiovascular disease is preventable and that it is possible to reduce cardiovascular mortality and morbidity by at least 5% per year over the next ten years in this country by effective preventive medicine programs.