[Can we modify the pathogenesis of coronary disease? Introduction]

Recently the European Societies of Cardiology Atherosclerosis and Hypertension have published a document of Recommendations on the Prevention of Coronary Disease in Clinical Practice. The information given in the document has proven that a reduction in cholesterol reduces the risk of the onset of new coronary as well as cardiovascular mortality. It has been accepted that such reduction can induce the regression of the atheroma plaque, and the slowing of its progression. In Spain cardiovascular mortality has progressively decreased since 1975. This is true for the coronary caused mortality and the secondary to a cerebrovascular disease, the latter being that where the greatest change has been noticed, as well as in women. Probably, this trend may be explained by a better control on hypertension, as well as by a more adequate hospital net. Spain has one of the lowest rates of mortality due to coronary disease among the industrialized countries. Nevertheless, the cardiovascular mortality is still the first cause of death in Spain. Spanish cardiologist are convinced that the relationship between the levels of cholesterol and coronary risk happened in Spain, in quantitative terms, differently than in Central Europe and the USA. They consider that the "Mediterranean diet" is the protective factor.