[Medical treatment of cardiovascular disease. A personal outlook towards the future].

Despite the striking advances in the treatment of cardiovascular disease during the last 30 years, the cardiovascular disease burden has continued to increase. The goal of future therapy should not be restricted to more effective, and costly, treatments, but will have to include strategies to impact on the atherogenic lifestyle of the welfare civilization. Future sanitary plans should facilitate physical activity and an healthier use of food. In this context, physicians should recall to themselves the important cultural role of educating patients and putting pressure on political decision makers. Also, a more aggressive drug therapy towards reducing the burden of traditional risk factors should be facilitated by specific resource allocation, possibly by reducing the present unwarranted and nonselective diagnostic excess. A more aggressive treatment of the acute phase of ischemic cardiovascular disease will have to be pursued by more extensive and timely use of treatments of proven efficacy, at present still adopted in a minority of cases. Since the damage caused by acute ischemic cardiovascular disease often results in invalidity, a more effective therapy of the acute phase has the potential for reducing secondary sanitary costs, particularly after acute myocardial infarction and stroke. Practice Guidelines, made available and continuously updated by the Scientific Societies, should be considered as the key referral sources for sanitary planning.