The development of many strategies for the prevention of cardiovascular disease (CVD) presents an important policy question for society: do the benefits of these programs and interventions justify the investment in them? Preventive strategies may provide attractive opportunities to avoid or defer disease and disability, but they may have substantial costs and must often be applied to many subjects in order to reach the few in the group who will benefit the most. Whether and how limited health care resources should be allocated to these activities is therefore an important area of inquiry for health care policy makers and practitioners.

Although primary prevention is more attractive on an emotional level, economic analysis usually finds secondary prevention to be more efficient. This is due to the rather simple fact that patients who have clinical disease are at higher risk, and therefore more likely to benefit, than a group of lower-risk subjects, only a few of whom will ever develop disease.