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Risk and disease

Peter H Schwartz1

  • 1Center for Bioethics, Indiana University School of Medicine, 410 W. 10th Street, Indianapolis, IN 46202, USA. phschwar@iupui.edu

Perspectives in Biology and Medicine
|August 30, 2008
PubMed

Insights

Many common diseases like hypertension and high cholesterol are diagnosed based on risk factors, not pathology. Treating these risk factors is crucial for reducing mortality, but they shouldn't be labeled as diseases.

Area of Science:

  • Medical Ethics
  • Preventive Medicine
  • Clinical Diagnosis

Background:

  • Disease definition is increasingly linked to modifiable risk factors.
  • Diagnostic thresholds are set at levels where intervention reduces future disease risk.
  • This approach risks reclassifying risk factors as pathological conditions.

Purpose of the Study:

  • To critique the trend of redefining risk factors as diseases.
  • To examine the classification of conditions like stage 1 hypertension and high cholesterol.
  • To argue against labeling risk factors as pathological entities.

Main Methods:

  • Critical analysis of diagnostic criteria for "risk-based diseases."
  • Examination of the philosophical and ethical implications of disease reclassification.
  • Review of evidence for treating modifiable risk factors.

Main Results:

  • Many diagnosed "diseases," such as stage 1 hypertension and high cholesterol, may not represent true pathological conditions.
  • Classifying risk factors as diseases has significant philosophical and ethical consequences.
  • Treating these risk factors remains vital for reducing morbidity and mortality.

Conclusions:

  • Conditions like hypertension and high cholesterol, while important risk factors, should not be pathologically defined.
  • Ethical and philosophical considerations necessitate a clear distinction between risk and disease.
  • Continued focus on treating modifiable risk factors is essential for public health.

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