Cardiovascular Disease Prevention Strategies

Whereas secondary prevention of cardiovascular events through risk factor modification in patients with known coronary and carotid artery disease is recognised as cost-effective, CVD prevention by drug therapy in asymptomatic individuals has shown only modest benefits and to be relatively expensive. These interventions, however, could be cost-effective when targeting individuals at high risk for an event. Based on easily assessable risk factors, high-risk persons for cardiovascular disease can be targeted. The aim of the studies described in this thesis was to search for the most costeffective way to prevent cardiovascular disease in the general population. The studies are based on data from the Rotterdam Study, a population-based cohort study composed of 7,983 men and women aged 55 years and over who live in a welldefined suburb of the city of Rotterdam, the Netherlands. Apart from the traditional cardiovascular risk factors, data were collected on the presence and severity of atherosclerosis and the occurrence of cardiovascular events during follow-up.

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