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International Journal of Epidemiology 2002;31:1129-1134
© International Epidemiological Association 2002

Point-Counterpoint

Commentary: Lifelong prevention of atherosclerosis: the critical importance of major risk factor exposures

Philip Greenlanda, Samuel S Giddingb and Russell P Tracyc

a Department of Preventive Medicine and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
b The Nemours Cardiac Center, Alfred I. DuPont Hospital for Children, Wilmington, Delaware, USA.
c Departments of Pathology and Biochemistry, University of Vermont, Burlington, VT, USA.

Correspondence: Philip Greenland, MD, Department of Preventive Medicine, The Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1102, Chicago, IL 60611, USA. E-mail: p-greenland@northwestern.edu

The first 150 words of the full text of this article appear below.

More than 40 years ago, a model that expressed then-prevailing concepts about atherogenesis1 proposed that atherosclerosis begins relatively early in life (ages 10–20 years) with deposition of the fatty streak, progresses (ages 20–30 years) to the fibrous plaque, and further advances from ages 30–50 years by the action of traditional risk factors such as cigarette smoking, unfavourable blood lipid and blood pressure levels, overweight and insulin resistance (or glucose intolerance related factors) and eventually results in occlusive plaques and clinical manifestations of the atherosclerotic diseases from approximately age 50 onward. In this issue of the International Journal of Epidemiology, Beaglehole and Magnus2 remind us that ‘traditional’ risk factors explain perhaps as much as 85% or more of the world’s experience with atherosclerosis. They state that research on further refinements of this model cannot add much to epidemiological knowledge of this disease, and they argue that more energy should be . . . [Full Text of this Article]


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