Prevention: some important steps forward, but many unmet needs in a world with cardiovascular disease as the leading cause of death

Abstract

![Graphic][1] Prevention is better than cure: the proverb remains as important as is has been for decades and centuries. Without a doubt, we have made substantial progress: we can lower blood pressure, if it is too high,1 we can treat hyperlipidaemia as again outlined in the 2016 ESC Guidelines,2 and indeed for the first time we can prevent cardiovascular mortality in diabetics3—nevertheless, we do not do enough, It is of note that many patients with high blood pressure do not reach recommended targets, many patients with hyperlipidaemia are inadequately treated or stop drugs when negative media reports appear,4 and diabetics are often far from being well controlled. Thus, the ‘ Epidemiological update 2016 for c ardiovascular disease in Europe ,5 by Nick Townsend and colleagues from the British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention in Oxford, UK comes at the right time to remind us of the unmet needs in cardiovascular medicine. Of note, the current report is the fourth in a series of papers describing the burden of cardiovascular disease within Europe. Not surprisingly, as the implementation of preventive measures is still less than perfect, cardiovascular disease remains the most common cause of death worldwide, with the 2013 Global Burden of Disease study estimating that cardiovascular disease caused 17.3 million deaths globally. It accounted for 31.5% of all deaths and 45% of all non-communicable disease deaths, more than twice that caused by cancer, as well as more than all communicable, maternal, neonatal, and nutritional disorders combined. The 2013 Global Burden of Disease study also reported that cardiovascular disease caused a greater number of deaths and was responsible for a greater percentage of all deaths than in 1990 when 12.3 million deaths were attributed to cardiovascular disease, corresponding to 25.9% of … [1]: /embed/inline-graphic-1.gif