Perspectives on prevention and medical education for the 1990s.

Heart disease and stroke have been the first and third leading causes of death, respectively, in the United States for many years, and the importance of primary and secondary prevention in reducing morbidity and mortality from these two disease entities has been well established. Additional confirmatory information continues to accumulate, but it is accepted that hypertension, smoking, and serum lipids are important risk factors in coronary heart disease and stroke. Although this discussion deals primarily with cardiovascular disease, many of the issues related to prevention and medical education are generic and are equally relevant to the prevention of other diseases, including HIV infection. Moreover, the way in which medical education approaches preventive cardiology is likely to be similar to the way in which prevention issues are approached in general.