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The relative influence of secondary versus primary prevention using the National Cholesterol Education Program Adult Treatment Panel II guidelines

Lee Goldman, MD, MPH, FACC^*, Pamela Coxson, PhD^*, Maria G. M. Hunink, MD, PhD, Paula A. Goldman, MPH, Anna N. A. Tosteson, ScD, Murray Mittleman, DrPh, MDCM^||, Lawrence Williams, MS^¶ and Milton C. Weinstein, PhD

^* Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California, USA
Department of Health Sciences, University of Groningen, Groningen, the Netherlands
Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA
Department of Clinical Research, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
^|| Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
^¶ Brigham and Women’s Hospital, Boston, Massachusetts, USA

View larger version (28K): [in a new window]   Figure 1 Additional quality-adjusted years of life (2000–2020). The shaded bar is for secondary intervention, the white bar is for secondary plus high-risk primary interventions and the black bar is for secondary and high-risk primary plus medium-risk primary intervention. The added years in each age range reflect the effects of the intervention in this age range as well as the delayed effects of intervention in earlier ages.

View larger version (25K): [in a new window]   Figure 2 Additional quality-adjusted years of life as a percent of person-years of treatment (2000–2020). The added quality-adjusted years of life (from Fig. 1) are displayed here as a percent of person-years of treatment.

View larger version (18K): [in a new window]   Figure 3 Annualized risk per 1,000 of coronary heart disease (CHD) death for women (2000–2020). Baseline values represent the risk to the population in the category if no intervention is implemented for that group. Postintervention values give the risk if NCEP guidelines are implemented as described in the text.

View larger version (20K): [in a new window]   Figure 4 Annualized risk per 1,000 of coronary heart disease (CHD) death for men (2000–2020). Baseline values represent the risk to the population in the category if no intervention is implemented for that group. Postintervention values give the risk if NCEP guidelines are implemented as described in the text.