Combatiendo la epidemia de enfermedad coronaria en Chile: Potencialidades y problemas en el control de los factores de riesgo

In this issue of the journal Lanas et al report an estimation ofpopulation attributable risk (PAR) for myocardial infarction (MI) derived from different riskfactors in Chile. Cigarette smoking, dyslipidemia and hypertension accounted for 71% of totalPAR. Mortality from MI has decreased in Chile, but epidemiologic surveys carried out indifferent hospitals across the country, strongly support that most of this effect comes from bettertreatment of MI. Recent changes in public health policies, favoring the treatment of hypertensionand diabetes may help control cardiovascular morbidity and mortality. However, a reallysignificant impact will be obtained when the development of the disease may be halted. Toevaluate this possibility, newer methods to diagnose atherosclerosis non invasively may come toour rescue. On the other hand, pharmacologic treatment of dyslipidemia and hypertensioncontinue to offer the most powerful way to decrease levels of cardiovascular risk factors.According to current knowledge, wise balance of non pharmacologic and pharmacologicmeans of primary prevention, with due respect for ethic aspects, is the most effective way tocurve the epidemic of coronary artery disease in Chile (Rev Med Chile 2008; 136: 551-4).(