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Evaluation & the Health Professions
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Heart Disease

Strategies for Prevention

Carl H. Slater

University of Texas, School of Public Health, Houston, TX

Bill Carlton

West Virginia University, Morgantown, WV

Gilbert Ramirez

United States Army, Fort Sam Houston, TX

Carol Ashton

Baylor College of Medicine, Houston, TX

There has been a continuing debate among health professionals concerning the appropriate strategy of use for the prevention of ischemic heart disease: a targeted high-risk group strategy or a community strategy. A careful review of the evidence demonstrates that neither approach can be recommended to the exclusion of the other. The results are, however, supportive of the lowering of serum cholesterol in high risk individuals. The inconclusiveness of these studies appears to be related to several problems, which are discussed in the text: statistical powerproblems, characteristics of the interventions, unique design problems associated with prevention trials, and problems related to the choice of modelsfor investigation and intervention. Several suggestionsforfuture research to address each of these problems are made.

Evaluation & the Health Professions, Vol. 10, No. 3, 255-286 (1987)
DOI: 10.1177/016327878701000302
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