[Epidemiologic evidence in the treatment of cardiovascular risk factors in Germany]

Up to now, approaches neither in primary nor in secondary prevention led to a relevant decline in prevalences of hypertension and hypercholesterolemia. On the contrary, prevalence of hypercholesterolemia increased from 38 to 40% (p < 0.001) while the hypertension prevalence stagnated (at nearly 20%) in the 30 to 69 years old population in West Germany between 1984/85 and 1991/92. The potential of medical advice is not sufficiently used, the compliance of patients regarding medical recommendations to change health behavior is limited. Subsequently the scientific consensus with regard to benefits from normalization of hypertension and hypercholesterolemia does not become effective at the population level. Evidence based medicine needs more efficient evaluation of continued medical education and quality assurance.