Although theoretically very effective and apparently quite straightforward, cardiovascular prevention leaves much to be desired in practice. Several reasons, including ethical, conceptual, psychological, and Klju~ne besede: sr~no-`ilne bolezni, prepre~evanje, dru`inska medicina Zdrav Var 20; 50: 75-8 doi 0.2478/v052-00-0030-9 Medical research has markedly improved the knowledge of etiology and prevention of cardiovascular conditions, particularly coronary heart disease (CHD), so that these disorders could virtually be eliminated. Indeed, several years ago, the global community was seemingly approaching the eradication of atherosclerosis, the leading cause of cardiovascular morbidity and mortality. Unfortunately, in reality the expectations had not been met: nowadays the decrease in CHD in economically developed countries is stagnant (), the prevalence of CDH is probably increasing (2), while in developing and transitional countries it is escalating (3). This gloom picture is often attributed to unavailability of or to a delay in using modern invasive procedures and new medications, particularly in patients with heart attack or stroke.Although this segment of management should not be neglected (e.g. prompt and accurate diagnosis, early initiation of treatment in family practice, faster transportation, better organization and distribution of adequately staffed and well equipped interventional units), the bulk of the problem lies at the other end of the clinical spectrum -in unsatisfactory prevention. The EURASPIRE III results (4) show that during the past decade the prevalence of obesity among coronary patients in Europe has increased from 25% to 38%, and that of diabetes from 7.4% to 28%, while smoking and hypertension rates remained unchanged, i.e. approx. 20 % and 60%, respectively. Which are the obstacles on the path to effective primary prevention of CHD, i.e. to adequate protection of apparently healthy, younger people against adverse Unauthenticated Download Date | 5/12/18 4:48 AM