CHD and stroke : Scotland`s pandemics also need co-ordinated and vigorous primary prevention programmes

Further reductions in the incidence and mortality from CHD and stroke in Scotland will be largely dependent upon changes in the three major risk factors – cholesterol, blood pressure and smoking. Vigorous and co-ordinated primary prevention programmes are therefore required. This paper outlines the main elements of such a prevention programme starting in the Scottish Borders. It considers the three major risk factors and discusses local action within high risk groups and within the population at large for each. The importance of considering environmental changes and social supports for change are emphasised, and because of this, the key role of local authorities and other local partners. Suggestions for action at the national level to encourage and support the growth of such programmes across Scotland are given.