Coronary Heart Disease Epidemiology Revisited

Epidemiological research relating coronary heart disease risk to risk factors has been reviewed and condensed into simple, diagrammatic form. The predictive power of risk factors for detecting susceptibles in the population is presented. While much is now known about long-term prediction, there is an urgent need for tests to signal impending heart attacks. Against this background, the potential for preventive action is discussed in the light of current knowledge. The “clinical-individual’ and “community’ approaches to prevention are contrasted. To what extent is prevention on the community level warranted, pending the results of controlled prophylactic trials? The view is presented that advice on preventive measures to the population at large is justified at this time, based on education and planned change but short of an all-out campaign which must await conclusive data from intervention studies.