[The link between cholesterol and coronary atherosclerosis: epidemiological evidence]

Epidemiology has shown close associations between the consumption of saturated fats, the level of serum cholesterol and the development of coronary atherosclerosis and coronary disease. Such associations are observed among populations as well as among individuals. The individual risk increases steadily from the lowest to the highest serum cholesterol values. In fact, this risk results from two conflicting effects: a positive association between the disease and LDL-cholesterol and a negative association with HLD-cholesterol. The risk is also influenced by other biological and environmental factors, and it is multifactorial. Primary prevention trials have provided evidence of a causal relationship between serum cholesterol (or its two components) and coronary disease. This set of epidemiological data is in good agreement with other available scientific knowledge, and its has important consequences on the organization of prevention and on medical practice.