The debate on the best way forward for primary prevention continues, and today cebmblog published:

Heneghan C. Considerable uncertainty remains in the evidence for primary prevention of cardiovascular disease [editorial]. The Cochrane Library 2011 19 Jan.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and therefore strategies that aim to improve prevention in people without existing disease (primary prevention) are important for managing the overall burden of disease. This edition of The Cochrane Library adds to the evidence-base in this area with publication of two Cochrane Reviews on such preventive strategies: multiple risk factor interventions for primary prevention of coronary heart disease, and statins for the primary prevention of CVD. read more

One of my major issues with primary prevention is:
'Given the current limitations of the evidence-base, the alternative approach for policy is to focus on population-wide prevention. Widely publicised by Geoffrey Rose,legislating for smoke-free public spaces, re-designing public spaces to improve exercise or reducing daily dietary salt intake prove generally effective and can be cost-saving interventions.'

If you haven't already read a copy of Rose's book, you should,
get yourself a copy now. It should be compulsary reading for commissioners, docs and anyone involved in health prevention.