RESEARCH RELATED TO RISK-FACTORS

The epidemic of premature coronary heart disease (CHD) in the U.S. and other Western industrialized countries is a result of modern lifestyles and the risk factors related to them. It is scientifically correct to designate habitual eating patterns high in cholesterol, saturated fats, calories as the primary cause of this epidemic. Such diets are responsible for the high prevalence rates in these populations of hypercholesterolemia, an established major CHD risk factor. Additional established major risk factors that enhance coronary proneness persons and populations with the lipid nutritional-metabolic prerequisites for severe atherosclerosis are hypertension and cigarette smoking. A sedentary lifestyle at work and leisure and incongruent behavior (e.g., the type A behavior pattern) are probable additional adjuvant risk factors in such populations. Data on the impact of major risk factors in one population enable prediction of risk in other populations. In populations with lifestyles rendering them generally coronary-prone, accurate assessment of CHD risk can be made at least from youth on, probably even in the first decade of life, enabling a preventive public-health strategy that combines efforts to improve lifestyles (diet, smoking and exercise) for the whole population from childhood (primary-habit formation) through middle age, with special concentrated attention to identified very high risk individuals and families.