On behalf of the Organizing Committee, we invite to participate in the 5th International Conference on Preventive Cardiology to be held in Osaka, Japan in May of 2001. This time the conference will be joined by the 4th International Heart Health Conference, because 2001 is the first year in which the 3- and 4-year cycles of the two meetings coincide.

The Scientific Program Committee is putting together an outstanding program under the theme of "Practicing Prevention for the 21st Century," which we have chosen to commemorate the opening of a new century.

Because of changes taking place in lifestyles and the public health environment, cardiovascular disease has become a major public health problem in most developed and developing countries. Recent extensions in life spans in many countries have also caused cardiovascular disease to become more prevalent. With this background, it is expected that making progress in geriatric medicine and in controlling cardiovascular disease will be one of the most important tasks for public health professionals, clinicians and research scientists in the 21st century.

It is needless to say that the first step in prevention of cardiovascular disease is lifestyle modification. Long-term drug treatments have also shown beneficial effects for the prevention of cardiovascular diseases such as hypertension, coronary heart disease and stroke.

The conference program will include topics covering the broad aspects of practicing prevention. Fruitful discussions based on an exchange of new ideas and new information and very much expected to contribute to the promotion of prevention both in developed and developing countries in the new century.

Osaka, the second largest city in Japan, is located in the center of the main island of Japan and is easily accessible from any part of the world. Neighboring cities such as Kyoto and Nara are well known as places that preserve Japan's ancient, traditional culture. We are planning various social programs through which you will be able to touch on some of the aspects of this culture.

We are looking forward to your participation to make the conference a success.

Sincerely,

Teruo Omae, M.D.	Tsuneaki Sugimoto, M.D	Hiroshi Yanagawa, M.D
President	Vice-president	Vice-president

Preventive Cardiology in the 21st Century

Preventive cardiology is a term from the last century. It encompasses both the population approach to prevention with public health measures and campaigns, as well as the individually oriented high risk approaches. The latter has become increasingly important as our understanding of the mechanisms leading to overt clinical disease has greatly improved, and effective prophylactic treatment developed. This has lead to a less clear distinction between treating those already affected, and the prevention of disease in the high risk individuals. There is no qualitative difference between avoiding a reinfarction in a patient having survived his or her first myocardial infarct, and the prevention of the first ischaemic event in a type-II diabetic. The risk for an ischaemic attack is of the same magnitude in both groups. This knowledge stems from large epidemiological studies as well as the intervention trials, and is now embedded in the most recent international guidelines.

The current cardiovascular trends are showing declining mortality rates in the industrialised part of the world whereas a second increasing wave is taking place in the developing world and the former eastern European countries. The sheer number of people exposed to this wave will increase the number of heart patients to revels never observed before, and the demand for effective prevention and postponement of premature event will expand correspondingly. This makes Japan and Asia a highly natural venue for the 5th International Conference on Preventive Cardiology which will take place as a Joint conference with the International Heart Health Conference (5th ICPC and 4th IHHC) May 27- 31, 2001. The conference slogan: Practicing prevention for the 21st century will address all the topics needed to implement rational measures against the new cardiovascular epidemic. Emphasis will be put on the epidemiology of CVD in developed and developing countries, CVD in women, the emerging epidemic of obesity and insulin resistance, the need for identifying genetically determined CVD risk factor susceptibility, further development of feasible and practicable guidelines, as well as more insight into why community programs and public measures are less successful than previously anticipated. Stroke prevention is of particular interest in the Asian world, and we welcome this opportunity to visit Japan which has managed effectively to reduce the stroke mortality rates both by public health measures as well as effective blood pressure control.

The World Health Organisation has placed tobacco on the world agenda, and the 5th ICPC will dedicate a substantial part of its effort and time on this issue, hoping that the joint actions may eventually turn the deadly tide of tobacco smoking.

The conferences on preventive cardiology have roots in the World Heart Federation's Ten Day Teaching Seminars on Epidemiology and Prevention which have been running for more than thirty years, and influenced thinking, learning and research in more than a thousand fellows. The 5th ICPC is a tribute both to the host country and to the farsighted researchers who founded the Teaching Seminars. We are honoured that Japan will welcome us to this important conference and are looking forward to May, 2001.

Dag S. Thelle, M.D.
President

Promoting Heart Health for All

The year 2001 will be the occasion of the 4th International Heart Health Conference (4th IHHC) to be held, for the first time, in conjunction with the 5th International Conference on Preventive Cardiology (5th ICPC). This is a once in a life time opportunity for all those interested in the heart and blood vessels, be it from the spectrum of health promotion through disease prevention to tertiary care, to gather and learn together.

As many will recall, the 1st International Heart Health Conference was held in Victoria, Canada in June of 1 992. This meeting produced the Victoria Declaration on Heart Health. This unique document outlined the scale of the global burden of heart disease and stroke and presented, for the first time, an international scientific consensus that heart disease was preventable and that enough was known about these conditions for comprehensive action to be taken. Barcelona was the site of the 2nd IHHC in 1995 when the global heart health community was again gathered. This meeting produced the Catalonia Declaration that outlined in some detail, examples of how heart and stroke disease could be successfully prevented and managed. This was quickly followed by a companion piece to the declaration. produced by the Centers for Disease Control in Atlanta, USA, which gave additional global experience in this regard.

Singapore was the host of the 3rd IHHC in September 1998. The Singapore Declaration was the product of this meeting and was titled "Forging the Will for Heart Health". With this document the International Advisory Board of the Conference outlined the nature and scope of the capacity needed if heart disease and stroke were to become relics of the 20th century. This Declaration emphasized the need for leadership at all levels in society and particularly the need for political will to undertake action if this great task is to become a reality.

Clearly much needs to be done if the vision and goals of the various heart health declarations are to be realized. Osaka 2001 and the Osaka Declaration that will result are intended to aid this process. This meeting in conjunction with the 5th ICPC will provide the forum where the gap between the science and policy with respect to heart disease and stroke can be examined and hopefully narrowed. On behalf of the Advisory Board of the 4th IHHC it is my pleasure to extend an invitation to the global heart health community to come to Osaka in May of 2001 to continue the attack on the world's biggest killer.

David R. MacLean, M.D.
Chair