Level 3 Level 3 requires advanced training to qualify as a director of a clinical service or research program, or both. Training to this level would require at least 1 year of a 36-month program. The basic science knowledge and clinical competence of the trainees must be evaluated regularly by the cardiovascular medicine program director. Trainees must be informed about the results of their evaluations. With increasing knowledge concerning the specific roles of the various risk factors in atherosclerotic and thrombotic diseases and vascular dysfunction, strategies aimed at the appropriate detection and modification of these risk factors now demonstrate the potential for slowing the progress of atherosclerosis and even regressing the process.
Recent data suggest an important reduction in adverse clinical sequelae in certain high risk groups.
The results of clinical experiences, clinical trials and published consensus reports establish that outcomes can be improved by promoting favorable life-style behaviors and treating identified abnormalities. When interventions are appropriately targeted, there is little debate that they can be both clinically and cost-effective. In contrast to the prevention of cardiac diseases, such as rheumatic fever and infective endocarditis, it is unlikely that such measures truly prevent the development of atherosclerotic disease, or the adverse events resulting therefrom, although a reduction in disease incidence and severity is probable, and fewer complications can be expected in many patients. Therefore, this Committee recommends that the College reaffirm and expand its policies regarding prevention of cardiovascular diseases. These actions of the American College of Cardiology serve to define the opportunities and responsibilities of cardiovascular specialists.