Overview

Abstract

The discovery in such large-scale prospective studies as the Framingham study that the presence of certain risk factors increased the subsequent risk of developing clinically apparent arteriosclerotic cardiovascular disease led to the hope and expectation that education of the public with regard to these findings would lead to changes in behavior and lifestyle that in turn would result in a reduced prevalence of the risk factors and, eventually, in the incidence of disease. While such public education efforts have undoubtedly played a role in the clear decrease in the incidence of strokes and the smaller, but still significant, decrease in the mortality rate associated with coronary heart disease over the past decade, it is nevertheless evident that much more remains to be accomplished. Since behaviors and lifestyles, whether they be cigarette smoking or failure to adhere to an antihypertensive regimen, are clearly involved in the continuing presence of the established risk factors, many leaders in biomedicine have been led to ask whether application of behavioral science knowledge and techniques might help to improve our efforts at prevention of arteriosclerotic cardiovascular disease through more effective approaches to risk factor reduction.