Abstract
The prevalence of coronary heart disease is increasing owing to improved survival and an aging population. Primary prevention should be targeted at those individuals with the highest global risk. Mass screening of the whole population to identify those at high risk is a relatively lowyield, high-cost option. Alternatively, we could target screening at population subgroups in which high-risk individuals are over-represented, such as those with a family history and deprived communities. This higher yield, lower cost option would nonetheless achieve good coverage of high-risk individuals in the general population. Surveys suggest that we currently have high levels of unmet need amongst those who would benefit most from primary prevention. Urgent action is required to address this.
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