ArticleBMJ (Clinical research ed.)2005
Modelling the decline in coronary heart disease deaths in England and Wales, 1981-2000: comparing contributions from primary prevention and secondary prevention.
Article in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 2 of them syntheses that pooled it.
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Who cites it
85 citing papers in PubMed, 2 syntheses or guidelines pooled it, 294 citations in OpenAlex.
- How To Support Smoking Cessation In Primary Care And The Community: A Systematic Review Of Interventions For The Prevention Of Cardiovascular Diseases.Vascular health and risk management · 2019Pooled it
- Canadian Cardiovascular Society position statement--recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease.The Canadian journal of cardiology · 2006 · on this mapGuideline
- Effects of a DASH-like diet containing lean beef on vascular health.Journal of human hypertension · 2014Trial
- Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study.European heart journal · 2011Trial
- The PreCardio-study protocol--a randomized clinical trial of a multidisciplinary electronic cardiovascular prevention programme.BMC cardiovascular disorders · 2007Trial
- Risk Factors for Cardiovascular Disease: Epidemiology, Screening, Prevention, and Therapeutic Interventions.MedComm · 2026Review
- Changes in Cardiometabolic Risk Factors and Ischaemic Heart Disease Mortality Between 2000 and 2015: A Global Ecological Analysis.Medicina (Kaunas, Lithuania) · 2026Article
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- Blood pressure measurements for diagnosing hypertension in primary care: room for improvement.BMC primary care · 2024Article
- Cardiovascular disease in hereditary haemophilia: The challenges of longevity.British journal of haematology · 2022Review
- Cryptotanshinone alleviates myocardial ischemia and reperfusion injury in rats to mitigate ER stress-dependent apoptosis by modulating the JAK1/STAT3 axis.American journal of translational research · 2022Article
- The impact of Thai multidisciplinary smoking cessation program on clinical outcomes: A multicentre prospective observational study.Frontiers in public health · 2022Observational
- Lay knowledge of cardiovascular disease and risk factors in three communities in Accra, Ghana: a cross-sectional survey.BMJ open · 2021Article
- Unwillingness to participate in health checks for cardiometabolic diseases: A survey among primary health care patients in five European countries.Health science reports · 2021Article
- Decline of coronary heart disease mortality is strongly effected by changing patterns of underlying causes of death: an analysis of mortality data from 27 countries of the WHO European region 2000 and 2013.European journal of epidemiology · 2021Article
- High Variability in Implementation of Selective-Prevention Services for Cardiometabolic Diseases in Five European Primary Care Settings.International journal of environmental research and public health · 2020Article
- Do age, period or cohort effects explain circulatory disease mortality trends, Scotland 1974-2015?Heart (British Cardiac Society) · 2020Article
- Explaining the increment in coronary heart disease mortality in Mexico between 2000 and 2012.PloS one · 2020Article
- Inter-Individual Variability in Metabolic Syndrome Severity Score and VOInternational journal of environmental research and public health · 2019Article
25 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether population based primary prevention (risk factor reduction in apparently healthy people) might be more powerful than current government initiatives favouring risk factor reduction in patients with coronary heart disease (CHD) (secondary prevention). DESIGN, SETTING, AND
participantsThe IMPACT model was used to synthesise data for England and Wales describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in healthy people and in CHD patients.
resultsBetween 1981 and 2000, CHD mortality rates fell by 54%, resulting in 68,230 fewer deaths in 2000. Overall smoking prevalence declined by 35% between 1981 and 2000, resulting in approximately 29,715 (minimum estimate 20 035, maximum estimate 44,675) fewer deaths attributable to smoking cessation: approximately 5035 in known CHD patients and approximately 24,680 in healthy people. Population total cholesterol concentrations fell by 4.2%, resulting in approximately 5770 fewer deaths attributable to dietary changes (1205 in CHD patients and 4565 in healthy people) plus 2135 fewer deaths attributable to statin treatment (1990 in CHD patients, 145 in people without CHD). Mean population blood pressure fell by 7.7%, resulting in approximately 5870 fewer deaths attributable to secular falls in blood pressure (520 in CHD patients and 5345 in healthy people) plus approximately 1890 fewer deaths attributable to antihypertensive treatments in people without CHD. Approximately 45,370 fewer deaths were thus attributable to reductions in the three major risk factors in the population: some 36 625 (81%) in people without recognised CHD and 8745 (19%) in CHD patients.
conclusionsCompared with secondary prevention, primary prevention achieved a fourfold larger reduction in deaths. Future CHD policies should prioritise population-wide tobacco control and healthier diets.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.