Prevention of Myocardial Infarction

Coronary heart disease remains the leading cause of death in both men and women in most industrialized countries. Yet it is largely preventable, and health care providers can acquire the skills to help their patients reduce their risks substantially. Traditional risk factors such as cigarette smoking, hypercholesterolimia, hypertension, sedentary lifestyle, obesity and glucose intolerance explain a major proportion of coronary events. Recent evidence also suggests important adjunctive roles for hormone replacement therapy in postmenopausal women, and aspirin prophlaxis in individuals at high risk of a first myocardial infarction. Emerging evidence indicates an important role for diet in the prevention of heart disease. Although the importance of lifestyle and behavioral modifications may well be known among physicians and other health-care providers, the implementation of this knowledge has been limited. One reason is that the information supporting the value, feasibility and cost-effectiveness of risk-reduction strategies has not been previously synthesized and made widely available to health-care providers in office and community settings. Prevention of Myocardial Infarction fills these critical gaps by providing a state-of-the-art compendium of the scientific evidence on the efficacy of coronary disease prevention, while focusing on helping clinicians develop intervention skills to utilize available knowledge. Chapters by leading authorities in cardiovascular epidemiology, clinical cardiology, cost-effectiveness analysis, and public health translate the theory of preventive cardiology into feasible implementation. The counseling and other intervention strategies described in this textbook have documented clinical efficacy and cost-effectiveness, and they require little time to learn or implement. The book is written mainly for primary care providers, including general internists and family physicians, but will also be of interest to medical subspecialties such as cardiologists and endocrinologists, as well as medical students, dietitians, psychologists, epidemiologists, and students, practitioners, and researchers in public health.

Part I: Background1. J.E. Manson, et al: Myocardial Infarction: Epidemiologic Overview2. P.M Ridker: The Pathogenesis of Atherosclerosis and Acute Thrombosis: Relevance to Strategies of Cardiovascular Disease Prevention3. M. Dammerman and J. Breslow: Genetic Determinants of Myocardial InfarctionPart II: Modifiable Determinants of Myocardial Infarction and Intervention Strategies4. C.J. O'Donnell and J.E. Manson: Coronary Health Promotion: An Overview5. J. Taylor Hays, et al.: Smoking Cessation and Prevention of Myocardial Infarction6. L. Goldman: Cholesterol Reduction for the Prevention of Myocardial Infarction7. P.K. Whelton, J. He and L.J. Appel: Treatment and Prevention of Hypertension8. R.S. Paffenbarder, Jr. and I. Lee: Exercise and Fitness in the Primary Prevention of Coronary Heart Disease9. P.A. Daly, C.G. Solomon and J.E. Manson: Risk Modification in the Obese Patient10. J.E. Manson and A. Spelsberg: Risk Modification in the Diabetic Patient11. R. Allan and S. Scheidt: Stress, Anger and Psychosocial Factors for Coronary Heart Disease12. J.E. Buring and C.H. Hennekens: Aspirin in the Primary and Secondary Prevention of Cardiovascular Disease13. J.M. Gaziano and D. Steinberg: Prevention of Cardiovascular Disease by Natural Antioxidants14. W.C. Willett and E.B. Lenart: Diet in the Prevention of Coronary Heart DiseasePart III: Prevention of Heart Disease in Women: Special Issues15. N.K. Wenger: Gender Difference in Coronary Risk and Risk Factors16. F. Grodstein, J.E. Manson and M. Stampfer: Postmenopausal Hormone TherapyPart IV: Interventions in Childhood and Adolescence17. W.B. Strong and S.H. Kelder: Pediatric Prevention CardiologyPart V: Secondary Prevention18. P.H. Stone and F.M. Sacks: Strategies for Secondary Prevention19. P.M. Ridker and J.E. Manson: Future Directions in Coronary Disease Prevention20. J.E. Manson, et al.: Summary and Conclusions