In an evaluation of causes of these positive trends, a significant portion in the early years (1970-1990) was due to a decline in the new events of heart attack and stroke. Primary prevention through risk factor reduction predominated. However, in the more recent years, heart disease improvement tilted towards the beneficial effects of treatment and rehabilitation of those who are afflicted. Today, there is a balance between prevention of disease and effective treatment of it with both contributing to the improved situation we observe.
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