Death Rates from Coronary Disease — Progress and a Puzzling Paradox

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Abstract
In the late 1940s, recognition of coronary heart disease (CHD) as the leading cause of death in the United States prompted efforts to identify factors promoting its occurrence, in the belief that the resultant insights would advance knowledge of the pathophysiology of atherosclerotic cardiovascular disease and pave the way for its prevention. Hypertension, hypercholesterolemia, and cigarette smoking were identified by the early 1960s as principal risk factors for CHD.1,2 More recently, clinical trials of antihypertensive drugs and lipid-lowering therapies, along with investigations of smoking cessation, have documented the benefits of treating these risk factors and established beyond any doubt . . .