Atherosclerosis should be a rare disease in the lives of children born today

The spectacular fall in cardiovascular mortality that has occurred in most western societies in the past 40 years has contributed significantly to a steady rise in life expectancy. The Royal Dutch Actuarial Association has estimated, in its ‘Projection Table 2016’, that the life expectancy of a girl born in 2016 is 93.0 years and that of a boy born in 2016 90.1 years [1]. With a touch of optimism, these projections may in fact be an underestimation, since much of the potential for prevention of cardiovascular disease is still waiting to be used. Consistently, the fall in cardiovascular mortality in western societies is explained as the consequence of primary prevention, improved secondary prevention after a first event, and improved acute and chronic therapy for clinical events [2, 3]. For each of these elements, further improvements may be expected, as illustrated this month in the Netherlands Heart Journal. In this issue, current patterns of care for patients with ST-segment elevation myocardial infarction are highlighted [4]. The creation of national databases is particularly helpful in benchmarking and identifying best practices. In addition, they provide opportunities for large-scale evaluation of post-introduction changes in outcomes of interventions [5]. Together, these will assist in further improvement of clinical outcomes. Large-scale implementation of simple and low-cost preventive therapies, such as statins, will have a major impact on the burden of disease at a population level. Statins may even provide better outcomes of acute therapies such as per-