[Means and objectives of primary prevention in patients at high cardiovascular risk].

Since thirty years, cardiovascular mortality fell. That is linked, on the one hand, to an earlier and a more harsh care of the acute accident, and on the other hand, to development of the prophylactic treatment. But cardiovascular diseases stay the main cause of death in the most of western countries, in France in women, and in subjects over 65 years. That's why it is necessary to detect people with a high cardio-vascular risk before any complications so that they can be treated earlier and with an intensive mode. It relates to a global risk which is multifactorial, conducting to a treatment based on the evidence based medicine but also fitting to each patient and which requires his participation to the prevention. This is a 4P physical medicine: predictive, preventive, personalized and participative.