Epidemiology of coronary heart disease: the Framingham study.

Coronary heart disease continues to be the number one cause of death in most Northern European, North American and other industrialized Caucasian societies. By the age of 60, every fifth man and one in 17 women have some form of this disease. One in 15 men and women will eventually have a stroke. Other cardiovascular diseases related to atherosclerosis are also important. Epidemiologic (prospective) studies enable one to predict most of the potential victims of cardiovascular disease, years before they become ill. An increase in total to high-density lipoprotein cholesterol ratio, hypertension, cigarette smoking, excess weight, elevated blood sugar levels, lack of exercise, stress, electrocardiographic abnormalities, and other factors are associated with the development of these diseases. Intervention trials have generally shown that lowering "risk factors" reduces the subsequent rate of coronary heart disease, stroke, and other cardiovascular disease. Most highly susceptible subjects have problems with several risk factors. Management of one should not interfere with management of another if optimal health is sought.