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Prevention of coronary heart disease
To prevent heart disease physicians recommend that patients quit smoking; eat a diet in which about 30 percent of the calories come from fat, choosing polyunsaturated fats and avoiding saturated fat and trans fat; reduce high blood pressure; increase physical activity; and maintain weight within normal limits. Although the circumstantial evidence from many kinds of studies supporting these measures is impressive, not all these measures have been shown to be as effective as expected or predicted. Quitting smoking does lower the risk of cardiovascular disease—within a few years of quitting, patients show a risk factor for heart disease nearly equal to that of people who have never smoked. People with familial hypercholesterolemia (high cholesterol) benefit greatly from reduction of high levels of serum cholesterol. Rather surprisingly, studies suggest that even people who have borderline high cholesterol benefit from drugs that lower cholesterol. Results from studies in which participants modify their diet have had unexpected results, however, in that a low-fat diet does not seem to lead to reduced coronary risk. More studies on the effect of diet on heart disease are needed. And, although lowering blood cholesterol does have a great impact on heart disease, reducing high blood pressure has not been shown to lower coronary mortality as significantly.
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