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IJE Advance Access originally published online on March 11, 2005
International Journal of Epidemiology 2005 34(2):248-250; doi:10.1093/ije/dyi057
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.

Commentary

Commentary: Incubation of coronary heart disease—recent developments

Peter McCarron1,* and George Davey Smith2

1 Department of Epidemiology and Public Health, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, Ireland BT12 6BJ, UK
2 Department of Social Medicine, University of Bristol, Bristol, UK

* Corresponding author. E-mail: Peter.McCarron@qub.ac.uk

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

Over 20 years ago Geoffrey Rose, using data from the Seven Countries' study,1 reported that ecological correlations between cholesterol levels (and to a lesser extent blood pressure) and coronary heart disease (CHD) mortality were stronger for cholesterol measured many years before mortality was assessed, than if contemporaneous cholesterol measures and CHD mortality were correlated. Commenting for a tobacco company soon after publication, Peter Lee, criticized the analyses, and dismissed the evidence Rose used to propose that CHD has at least a 10 year incubation time as being ‘so weak as not to be worth publishing’.2 Rose, however, was aware of many of the weaknesses, and, anticipating Lee's final comment, advised that individual-level comparison of long-term and short-term predictive power should be undertaken.

Three main hypotheses flow from Rose's conclusions. First, CHD is set in train long before it manifests clinically; second, measuring risk factors earlier in life provides a better . . . [Full Text of this Article]


   Evidence for the early origin of CHD
 

   Lag period and CHD risk
 

   Early life salutogenic profile and later disease risk
 

   Attenuation by errors
 

   Application of Mendelian randomization
 

   Preventing future incubation of CHD
 

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