5 A leading cause of death worldwide (% of all deaths)5.1AIDS6Pulmonary disease9.1Injuries12.6Cancer17.8Infectious disease28.7Atherothrombosis*Atherothrombosis is the underlying condition that results in events leading to myocardial infarction, ischemic stroke and vascular death. As such, the leading cause of death of the estimated people worldwide who died in 2000 was atherothrombosis, manifested mainly as cardiovascular/cerebrovascular death. Other major causes of death were:AIDS (5.1%)Pulmonary disease (6%)Injuries (9.1%)Cancer (12.6%)Infectious and parasitic diseases (17.8%).1Reference1. The World Health Report 2002, WHO Geneva, 200251015202530Mortality (%)The World Health Report, 2002, WHO Geneva, 2002
17 SIMVASTATIN: Main conclusions After allowance for non-compliance, 40mg daily simvastatin safely reduces the risk of heart attack, of stroke, and of revascularisation by about one-third5 years of statin treatment typically prevents these “major vascular events” in about:100 of every 1000 people with previous MI80 " " " other CHD70 " " " cerebrovascular disease70 " " " other arterial disease70 " " " diabetes (age 40+)irrespective of cholesterol level (or age, or sex, or other treatments)Notes: none
41 Cost per life year gained TreatmentCost per year of life gained ($)Smoking cessation - physician counseling1300B-blocker post-MI, high-risk5,900Statins (4S)9,800AIDS drug cocktails20,000B-blocker post-MI, low-risk20,200Driver’s-side air bag27,000Kidney dialysis50,000Annual mammography for women 55-64110,000Exercise ECG for asymptomatic man 40 yrs124,000Cox-2 I for arthritis average risk for ulcers185,000Annual CT scan of heavy smokers to detect lung cancer2,300,000Source: J Probstfield, Am J Cardiol 2003: 91 (suppl): 22G – 27G Johannesson et al. N Engl J Med 1997; 336: 332–336; T O Tengs, Risk Analysis 1995: 15, 3, ;
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