Failure to Reduce Incidence of Ischemic Heart Disease by Lowering Blood Lipids

Abstract

Cardiovascular diseases continue to represent the major cause of morbidity and mortality in the developed countries, especially in young men, despite the considerable efforts and funds expended in the effort to explain and reverse the atherosclerotic process by studying and modifying fat intakes. Ischemic heart disease (IHD) is responsible for over 54% of all deaths in the United States (U.S. Dept. HEW, 1970); it is the major cause of death in most affluent communities (Editorial, Brit Med J, 1972). That the problem has increased during this century, particularly in young and middle-aged men, is indicated by two types of studies: (1) retrospective analyses of large numbers of necropsies (over 6000 each) in a large city hospital (Saphir et al., 1956) and from the Armed Forces Institute of Pathology (Pettyjohn and McMeekin, 1975); and (2) examination of the hearts of military men coming to autopsy in World War II (Yater et al, 1948, 1951; Moritz and Zamcheck, 1947), the Korean War (Enos et al., 1955), and the Vietnamese War (Macomber, 1971; McNamara et al., 1971; Wroblewski, 1971), and of victims of aircraft fatalities (Glantz and Stembridge, 1959). The study at Michael Reese Hospital in Chicago (Saphir et al., 1956) showed that there was an increase in frequency of coronary artery disease in subjects under 50 from 5.9% in 1920–1939, to 14.1% in 1940–1949, to 25.5% in 1950–1953. This did not take into account the almost twofold greater frequency of IHD in men than women.