Primordial Prevention: The Path from Victoria to Catalonia

Primordial prevention seeks to prevent future disease by influencing its social determinants. Henry Blackburnʹs writings are prime portrayals of social factors causing premature cardiovascular disease (CVD). His classic paper, Diet and Mass Hyperlipidemia, identified changes needed in professional attitudes, medical economics, food production, food labeling, and food advertising. The 1982 WHO report, Coronary Heart Disease (Blackburn, rapporteur), introduced the term “primordial prevention,” starting a cycle of initiatives, all with considerable influence worldwide. He participated in the now widely disseminated Victoria Declaration on Heart Health (1992), which contained 64 policy recommendations, many focussing on broad social forces that influence modern CVD epidemics. The path he initiated led to the Catalonia Declaration: Investing in Heart Health (1996), which echoed many of his pleas for resources necessary to influence CVD rates. Some roots of CVDʹs recent decline in many countries are thus clearly attibutable to Blackburnʹs prescient wisdom and visionary scholarship.