Epidemiological risk factors of coronary heart disease are not causal in atherosclerosis

Area of Science:

• Cardiovascular Science
• Pathogenesis of Atherosclerosis
• Epidemiological Methodology

Background:

• Atherogenesis requires a defined cause, not merely statistical associations.
• Current epidemiological practices often conflate correlation with causation for coronary heart disease (CHD).
• Extrapolations from CHD incidence to atherosclerosis are scientifically invalid without pathological evidence.

Purpose of the Study:

• To advocate for a rigorous definition of "cause" in atherogenesis research.
• To critique the misuse of "risk factors" in epidemiological studies of atherosclerosis.
• To emphasize the need for pathological and experimental validation of causal factors.

Main Methods:

• Logical deduction based on scientific principles.
• Critique of current epidemiological terminology and practices.
• Application of Koch's postulates for etiological validation.

Main Results:

• Statistical associations (risk factors) are insufficient to establish causality in atherogenesis.
• The term "risk factor" promotes a false concept of causality, hindering medical progress.
• Misuse of terminology impedes scientific integrity in cardiovascular research.

Conclusions:

• True scientific progress in atherogenesis necessitates strict adherence to causal logic.
• Abandoning the term "risk factor" is essential for advancing the understanding and treatment of atherosclerosis.
• Re-establishing precision in scientific language is vital for medical integrity.