CVD prevention and control: missed opportunities
Although many cardiovascular diseases (CVDs) can be treated or prevented, an estimated 17.1 million people die of CVDs each year. A substantial number of these deaths can be attributed to tobacco smoking, which increases the risk of dying from coronary heart disease and cerebrovascular disease 2–3 fold. The risk increases with age and is greater for women than for men. In contrast, cardiac events fall 50% in people who stop smoking and the risk of CVDs, including acute myocardial infarction, stroke and peripheral vascular disease, also decreases significantly over the first two years after stopping smoking.
Continuing to smoke after myocardial infarction or coronary revascularization can have serious clinical consequences. Even eight years after myocardial infarction, the mortality of post-myocardial infarction patients who continue to smoke is double that of quitters. Further, those who do not stop smoking after coronary revascularization also have a two-fold higher risk of re-infarction and death.
Studies indicate that although doctors are knowledgeable about the risks of CVDs associated with tobacco smoking, they are not sufficiently prepared to help their patients stop smoking. Even though physicians identify a substantial number of smokers during consultations, for example, many patients do not receive counseling to help them quit. Smoking cessation is the most cost-effective intervention for patients with documented CVDs, and efficacious programmes have been developed. The challenge is to get these programmes more widely used, and doctors and nurses should seize every opportunity to encourage patients to stop smoking.
The mission of the WHO Cardiovascular Diseases Program is to provide global leadership in the prevention and control of CVDs, and to assist Member States reduce the toll of morbidity, disability and premature mortality due to CVDs.