Preventing heart disease and stroke: messages from the United States

After rising steeply in the United States for the first two-thirds of the century, mortality from cardiovascular disease in the United States has declined sharply in the past 40 years. In addition to advances in the treatment of clinically manifest cardiovascular disease, the decline in deaths from cardiovascular disease results from a decline in tobacco consumption, decreased serum cholesterol levels, and improved control of hypertension. However, recent changes in risk factor levels are a cause for concern. These changes include sharp increases in smoking among young adults; increases in obesity and type II diabetes; a decrease in physical activity; and, a decline in hypertension control. In order to reduce the burden of cardiovascular disease in Olmsted County, Minnesota, we organized CardioVision 2020 (www.cardiovision2020.org). CardioVision 2020 is a population-based, multi-faceted, collaborative project based on personal commitment and community action.