Abstract

Cardiovascular diseases (CV) are the leading cause of death in European countries including Estonia and the expenses for their prevention and treatment are increasing rapidly. Recent investigations have expanded the understanding of the epidemiology and pathogenesis of CV. According to the theory of life course approach,the burden of CV depends of many interacting factors including enviromental and social factors. They may determine the health status of inviduals during the whole lifetime starting from the natal period. Hereditary factors may also predispose to development of CV. Ecological approach to the health status and predisposition to CV points to the importance of various enviromental factors, including pollution of air and food, in the pathogenesis and epidemiology of CV. Several  pschyco-social factors as social status, level of salary, stressful situations at work and in the family are also determinants of CV.
Various strategies have proved effective for prevention of CV. Activities for correction of the lifestyle, alimentary habits and increasing of physical activity have significantly lowered mortality from CV.
Evidence based treatment and the intervention strategies implemented during recent decades have effectively improved the quality of life of patients, and reduced mortality after cardiovascular events. Many investigations have demonstrated the effectiveness of the drugs acting on the renin-angiotensin system (AKEI and ARB) for treatment and secondary prevention of serious cardiovascular events and for lowering mortality.