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The High Public Burden of Low Individual Risk

Michael S. Lauer, MD

JAMA. 2007;297:1376-1378. Published online March 25, 2007 (doi:10.1001/jama.297.12.1376).

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Physicians and many laypeople are well aware of the substantial risks posed by asymptomatic atherosclerosis.¹ Among 50-year-old adults enrolled in the Framingham Heart Study, the lifetime risk for developing symptomatic disease was 52% in men and 39% in women.² For many patients the first clinical manifestation is a potentially catastrophic event, such as stroke, myocardial infarction, or sudden death.¹ Despite numerous advances in the understanding of the epidemiology and prevention of clinical atherosclerosis, the public disease burden remains high and may, with the current obesity epidemic, be increasing.³ Primary prevention, that is preventing or delaying clinical disease among asymptomatic individuals, therefore remains an issue of major public health interest.

Guidelines for clinicians caring for asymptomatic adults focus on assessment of individual risk, lifestyle interventions, and, when appropriate, pharmacological strategies, including aspirin⁴ and lipid-lowering drugs.⁵ One recommended approach^{4, 6} starts with estimating risk of clinical events using the . . . [Full Text of this Article]

Author Affiliations: Departments of Medicine, Epidemiology, and Biostatistics, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio. Dr Lauer is also Contributing Editor, JAMA.

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