[Pharmacologic interventions in primary prevention: lipid lowering drugs, aspirin, antiobesity drugs, and antihypertensive agents]

Abstract

Heart disease, particularly coronary heart disease is a major cause of morbidity and mortality in developed countries. Cardiovascular disease accounts for more than 50% of deaths. Drug therapy is highly effective for treatment of patients after a first cardiovascular event (secondary prevention). In contrast, introduction of drug therapy for lowering cardiovascular risk before a first cardiovascular event (primary prevention) is discussed controversially. The number of persons who need to be treated for prevention of one cardiovascular event is high and drug therapy in more or less "healthy" people is justified only after accurate assessment of potential risks and possible beneficial effects. Drug therapy combined with non-pharmacological treatment strategies is considered to be appropriate in selected high-risk persons for primary prevention. The following article describes potential indications of several drugs, in particular cholesterol-lowering therapy, aspirin, drug therapy of obesity and hypertension, for use in primary prevention of cardiovascular disease.