Prevention of cardiovascular risk factors in the first place

Cardiovascular disease (CVD) prevention can ad- dress the major risk factor s-blood lipids, blood pressure, and smoking-and their determinants througho ut the lifespan, with approaches varying according to age and risk. The Tas k Force on Research in Epidemiology and Prevention of Cardiovascular Diseas es gave new impetus to the concept of early intervention: Their highest pri ority in CVD prevention, was "to prevent the development of CVD risk in the first place," Six issues follow: (1) the relation between "primordial prev ention" of CVD and "prevention of the risk factors in the first place"; (2) the place of youth in context with older and younger age groups; (3) the i mportance of bridging institutional gaps between youth and adulthood; (4) t he need to strengthen the scientific base linking the major risk factors (e .g., blood cholesterol: concentration) with their determinants; (5) the val ue of rate of change in risk factors with age, and not only incidence of "t reatable" levels of risk factors, as an outcome in assessing interventions; and (5) the? role and appropriate, design strategies for both observationa l and intervention studies. It is time for a radical expansion of our inves tment in preventing the risk Factors in the first place. (C) 1999 American Health Foundation and Academic Press.