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Editorials

Cardiovascular Disease Surveillance in the Comparative Effectiveness Landscape

Véronique L. Roger, MD, MPH

From the Department of Health Sciences Research and Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn.

Correspondence to Véronique L. Roger, MD, MPH, 200 First Street SW, Rochester, MN 55905. E-mail roger.veronique@mayo.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

As the leading cause of death in the Western world, cardiovascular disease (CVD) constitutes an enormous public health problem.¹ The last 4 decades have been characterized chiefly by the postponement of CVD events and CVD related deaths until older age. Thus, the burden of CVD is increasing in parallel with the increase in life expectancy.² Within this context, identifying persons with CVD, measuring its incidence and outcome and how these vary over time and across populations is essential. A central goal of this monitoring (otherwise termed surveillance) has been to understand the determinants of the trends in CVD and in particular the respective responsibility of primary prevention versus that of the care of established disease in the genesis of the CVD trends. A direct extension of surveillance is its application to assess the effectiveness of care and the response to interventions designed to improve the quality of care.

Articles see pp 414, 475, and 508

Over the first year of its existence, the journal Circulation: Cardiovascular Quality and Outcomes published 3 important articles that illustrate the clinical relevance of surveillance and the applicability of trend studies to care improvement.

The article by Lewsey et al constitutes a classic example of CVD surveillance.³ The authors present much needed data on recent (1986 to 2005) trends in the epidemiology of stroke indicating that age- and sex-specific incidence rates of fatal and nonfatal hospitalized strokes in Scotland declined in men from 235 (95% CI, 229 to 242) to 149 (144 to 154) . . . [Full Text of this Article]

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				H. M. Krumholz One Year at Circulation: Cardiovascular Quality and Outcomes Circ Cardiovasc Qual Outcomes, September 1, 2009; 2(5): 399 - 401. [Full Text] [PDF]