[Coronary heart diseases--epidemiology 1984]

Epidemiology is the basic science of preventive medicine, within the present context preventive cardiology. The thesis that premature coronary heart disease is preventable to a large extent is based on the concept of risk factors and the further thesis that there is a cause-and-effect relationship between these factors and the disease itself. The latter view has been more and more firmly supported during the past 30 years. Apart from the major risk factors serum lipids, blood pressure and smoking, a series of other factors play a role in the development and, particularly, the progression of coronary heart disease. The risk factors are determined to an appreciable degree by environmental influences and thus subject to change. The present state of knowledge with regard to living habits, including nutrition, in their effect on risk factors has been summarized, followed by a review of intervention studies which aim at documenting the effectiveness of preventive measures through changes in life style and by pharmaceutical means. The sum total of all scientific data; not only from epidemiological research but also clinical, experimental and pathological findings, lead to the conclusion that the application of preventive measures is indicated both for persons at high risk and the general population.