Lifestyle and Cardiovascular Health:  Individual and Societal Choices

As part of the epidemiologic transition into the 21st century, chronic diseases—specifically, cardiovascular diseases—have become the leading cause of death and disability in most countries in the world.¹ Hence, clinical and public health interventions must aim at reducing the burden of cardiovascular disease in populations. Secular trends in cardiovascular disease morbidity and mortality indicate that some progress has been made, and cardiovascular mortality has decreased. However, the incidence of cardiovascular disease has remained largely stable over the past 2 decades, which, given the decrease in cardiovascular mortality, suggests that medical care was a major contributor to the decrease.² These epidemiologic data integrated within the context of unsustainable health care expenses define a burning platform for prevention. Two thought-provoking articles in this issue of JAMA provide an opportunity to reflect on cardiovascular disease prevention and consider the individual vs societal responsibilities in relation to health.