Prevention of cardiac disease: lifestyle modification or pharmacotherapy?

Cardiovascular disease is still the leading cause of death in Australia. There have recently been significant advances in the management of acute coronary syndromes, as well as secondary prevention strategies; however, much of our resources are still directed towards treatment rather than prevention. Prevention of cardiovascular disease involves first, identifying patients at greatest risk of cardiovascular events and second, managing modifiable risk factors. Both pharmacotherapy and lifestyle modification are useful in modifying risk factors; however, the relative importance of each is often dictated by the risk factor profile of the individual. Although there is growing evidence that those at all levels of risk may benefit from lifestyle modification, pharmacotherapy is likely to be most useful in those at higher risk.