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Contribution of the risk factor concept to patient care in coronary heart disease.

Abstract：

:This article deals with the question of whether or not the risk factor concept, a principal aspect of preventive cardiology, has contributed to patient care in coronary heart disease. The risk factors considered are plasma cholesterol, high blood pressure, smoking, diabetes and marked obesity. With the exception of plasma cholesterol and diabetes, all of these factors enhance myocardial oxygen consumption and thus, in the presence of coronary insufficiency, promote myocardial ischemia. Their modification is therefore good general medical practice, even if not related to coronary atherosclerosis. Diabetes needs adequate medical treatment in patients both with and without coronary atherosclerosis. Because of the occasional occurrence of spontaneous regression of coronary atherosclerosis and the morphologic and functional complexity of coronary artery pathology, it has never been and probably never will be demonstrated that lowering plasma cholesterol levels by diet or other means will cause regression of coronary atherosclerosis. It follows that modification or treatment of risk factors is implemented for good medical reasons but does not demonstrably or predictably affect coronary artery disease. It is concluded that the contribution of the risk factor concept to patient care in coronary heart disease has been, and still is, trivial.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Meijler FL

doi

10.1016/s0735-1097(83)80006-0

subject

Has Abstract

pub_date

1983-01-01 00:00:00

pages

13-9

issue

1

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(83)80006-0

journal_volume

1

pub_type

杂志文章

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