[Preventive cardiology in the Czech Republic. Present status and perspectives]

Despite their proclaimed goals, prevention campaigns were little effective in the past. Now it is time to discard those highly publicized programmes. Preventive cardiology can be successful in reducing the incidence and mortality only on condition the endeavor of the public health system is combined with a well functioning service of general practitioners and family physicians. The nationwide model of prevention should be translated into practice by institutes of public health and hygiene and should improve, mainly by redefining the dietary habits and smoking cessation programmes, the risk profile of the entire population. It should be remembered that even a minor change in the risk profile in the whole population has society-wide implications and entails a significant decrease in the number of clinically manifest cases of the disease. While secondary prevention after myocardial infarction will continue to be the responsibility of the cardiologist, individualized intervention in persons at high risk, as part of primary prevention, can be provided generally only on condition it is performed by the general practitioner and the family physician. All multi-level models designed to refer patients and persons at risk step by step, according to the degree of risk, up the health system, as proposed by socialist health care, are not practicable. Today, the general practitioner can consult the expert directly should the need arise. Successful prevention will depend on the standard and education of the general practitioner on the one hand, and the performance of public health institutions on the other.(ABSTRACT TRUNCATED AT 250 WORDS)