Euphenic prevention of coronary artery disease

The purpose of this feasibility study was to incorporate the primary prevention of coronary artery disease (CAD) into periconception care. The first task was the preconceptional screening for CAD. The family and case histories and risk status of prospective mothers and fathers were obtained. Serum total cholesterol was measured in 3,530 female and 3,127 male participants. The mean serum nonfasting cholesterol was 192 +/- 40 mg/dl in women and 204 +/- 49 mg/dl in men. The levels of total cholesterol exceeded the upper limit of desirable total cholesterol (200 mg/dl) in 37% of women and in 49% of men. Only 7% of women and 5% of men had previous knowledge about their high total cholesterol. The second task was risk assessment for CAD in prospective parents and their planned baby and the identification of couples at high risk. The third step was the education of couples at high risk: how to reduce risk factors and how to enhance protective factors. Three months later, the short-term follow-up study indicated a 49 mg/dl (18%) and 43 mg/dl (16%) (range 250 to 300) reduction in total cholesterol in female and male participants, respectively, mainly due to an education program including change in diet, cessation of smoking, and so forth. The long-term follow-up will include both parents and children 3 years after the birth. Periconception care is appropriate for both a general and selective approach to population screening for total cholesterol and for primary prevention of CAD.