Section I: RAS manipulation A. Epidemiology update Cardiovascular disease: No. 1 killer in US Content points: Cardiovascular disease is the leading killer of the US population, responsible for 46% of deaths in men and 53% of deaths in women.1 Cardiovascular disease is a primary or contributing cause in 60% of all deaths, which means that of the >2 million deaths from all causes in 1999, cardiovascular disease was listed as a primary or contributing cause on about 1.4 million death certificates. Cardiovascular disease claims as many lives as the next 7 leading causes of death including cancer, chronic lower respiratory diseases, accidents, diabetes (men), and influenza and pneumonia (women). According to the most recent government computations, the probability at birth of eventually dying from major cardiovascular diseases is 47%; by comparison, the chance of dying from cancer is 22%. According to the same study, if all major forms of major cardiovascular disease were eliminated, life expectancy would rise by almost 7 years. If all forms of cancer were eliminated, life expectancy would increase by 3 years.

Optimizing the use of evidence-based CHD therapies would save lives Content Points: Although coronary heart disease (CHD) is the leading cause of death in the US, many patients are not receiving therapies that have been shown to lower mortality from CHD in a series of landmark trials.2 Bahit and colleagues estimated the number of additional lives that could be saved by increasing the use of antiplatelet therapy, ß-blockers, angiotensin-converting enzyme (ACE) inhibitors and statins in patients with CHD. Optimal use of ACE inhibitors would save 30 600 lives, statins 27 600 lives, antiplatelet agents 13 500 lives, and ß-blockers 12 600 lives.