Introduction Cardiovascular diseases are a major component of non-communicable
diseases and include coronary heart disease, stroke and peripheral vascular
disease. Public health strategies to address cardiovascular disease require
three elements: surveillance, health promotion, and individual health care.
Methods Surveillance includes monitoring of mortality and morbidity as well as
surveys to monitor risk factors levels in the community. Data on mortality
from cardiovascular diseases are readily available and analysed by age and
sex specific rates looking are secular trends, geographical and ethnical group
variations and international comparisons. However many deaths from
cardiovascular disease occur suddenly and the cause of death may be
registered without autopsy or any other validation. Cardiovascular morbidity
information is more difficult to collate and interpret as it is closely related to
availability and access to health care. Periodic surveys of cardiovascular risk
factors are essential in monitoring the underlying trends in blood pressure,
smoking, cholesterol, obesity, and diabetes as they predict future trends, and
support planning for prevention and healthcare.
Results Prevention and health promotion activities are informed by the levels and
trends in cardiovascular disease and its risk factors. There has been debate
about population health promotion and individual health care strategies, but
both are necessary. Cigarette smoking, nutrition and physical exercise are the
main behaviours to be addressed but these are complex and require
multifaceted approaches. Education alone is insufficient to change health
behaviours and health promotion needs to look to changing attitudes.
Legislation, taxation and other fiscal interventions have been shown to be
effective however these can be difficult for legislators as there are other
competing interests, particularly in the area of nutrition and tobacco. Creating
health promoting environments that make healthy behaviour choices easier
can be beneficial.
Conclusions Health care interventions are also effective in reducing the burden of
cardiovascular disease. A balanced approach of health promotion and
individual health care is recommended in the development of a strategy for
cardiovascular disease.