Community control of cardiovascular diseases. The pro and cons

The need for an effective control of cardiovascular diseases is evident. Possibilities to achieve this both in the curative and the preventive field are restricted mainly due to the insufficient knowledge of their etiopathogenesis. Although the cause is not known, the discovery to risk factors provides a sound evidence for prevention. Attempts to reverse elevated risk factor levels are all directed towards a more healthy way of life. Group oriented prevention is one of the most frequently applied approaches to test the hypothesis of preventability. While it offers many advantages, the delayed timing of the intervention and the restricted coverage limits the possibility of inference from its results. The community approach implies acting on the whole population by changing their behaviour towards a more healthy way of life. Apart from the beneficial "side effects" on other chronic diseases, their outcome in the pilot areas may be inferred to the total population. The final proof of any scientific evidence from the public health point of view is, after all, its applicability and effectiveness in real life situation.