Abstract

The prevention of coronary heart disease (CHD) has made many advances since the North Karelia Project was started. This was a community prevention programme, which later led to an increased awareness of CHD risk factors in the whole of Finland. Since the early 1970’s CHD mortality has decreased by approximately 70% in middle-aged Finnish men and women. This dramatic change has been accompanied by reductions in three major CHD risk factors: serum cholesterol, blood pressure and cigarette smoking. Despite the favourable trend in CHD mortality, the Finnish population is still at high risk compared to most other European populations. In order to maximize the efficacy of prevention and treatment of cardiovascular disorders, the national Current Optimal Treatment Programme (Käypä Hoito) has been launched. Following the publication of the guidelines for treatment of nicotine addiction and hypertension, the guideline for treatment of dyslipidemia was published in 2004. This guideline has lowered the cholesterol targets (for serum cholesterol below 5 mmol/l and for LDL-cholesterol below 3 mmol/l but in high-risk individuals: for serum cholesterol <4.5 mmol/l and for LDL-cholesterol <2.5 mmol/l) and emphasized the need for rapid and aggressive drug therapy in high-risk individuals (including patients with established diabetes mellitus).