Review of Clinical Studies on the Quantification and Progression of Atherosclerosis
Beginning in the early 1950s, a number of epidemiologic population studies were carried out to identify those persons who were at high risk for the development of atherosclerotic disease and death. The most notable of these population studies is the Framingham Study, supported by the National Heart, Lung, and Blood Institute (NHLBI) (1). This large community study of an asymptomatic population with subsequent long-term follow-up has firmly established a relationship between certain clinical risk factors and the development of clinical manifestations of atherosclerotic disease. The most important risk factors that have been identified are age, sex, cigarette smoking, serum cholesterol levels, hypertension, family history, and diabetes. A shortcoming of the epidemiologic community studies is that they are most useful in identifying high risk that is concentrated on the high end of the frequency distribution for each of these particular risk factors. Rose (2) has pointed out that a strategy of atherosclerotic disease control based on a few persons with high values for these individual risk factors is not likely to contribute much to the control of the disease as a whole. This can be illustrated by using the cholesterol data from men, aged 55 to 64, in the Framingham Study.
KeywordsFramingham Study Atherosclerotic Vascular Disease Lipid Research Clinic Control Intervention Study Coronary Artery Surgery Study
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- 1.Kannel WB, Gordon T, Sorlie P (eds) (1971) The Framingham study: an epidemiological investigation of cardiovascular disease. Section 27: coronary heart disease, atherothrombotic brain infarction, intermittent claudication-a multivariate analysis of some factors related to their incidence: Framingham study, 16-year followup. Government Printing Office, Washington, DCGoogle Scholar
- 6.Mock MB, Ringqvist I, Fisher LD, Davis KB, Chaitman BR, Kouchoukos NT, Kaiser GC, Alderman E, Ryan TJ, Russell RO Jr, Mullin S, Fray D, Killip T III, and participants in the Coronary Surgery Study (1982) Survival of medically treated patients in the Coronary Artery Surgery Study ( CASS) registry. Circulation 66: 562–574Google Scholar
- 7.Vlietstra RE, Frye RL, Kronmal RA, Sim DA, Tristani FE, Killip T III, and participants in the Coronary Artery Surgery Study (1980) Risk factors and angiographic coronary artery disease: A report from the Coronary Artery Surgery Study ( CASS ). Circulation 62: 254–261Google Scholar
- 8.Shub C, Vlietstra RE, Smith HC, Fulton RE, Elveback LR (1981) The unpredictable progression of symptomatic coronary artery disease: A serial clinical-angiographic analysis. Mayo Clin Proc 56: 155–160Google Scholar
- 10.Campeau L, Lespérance J, Hermann J, Corbara F, Grondin CM, Bourassa MG (1979) Loss of the improvement of angina between 1 and 7 years after aortocoronary bypass surgery: Correlations with changes in vein grafts and in coronary arteries. Circulation 60: 1–5Google Scholar
- 11.Brensike JF, Kelsey SF, Passamini ER, Fisher MR, Richardson JM, Loh IK, Stone NJ, Aldrich RF, Battaglini JW, Moriarty DJ, Myrianthopoulos MB, Detre KM, Epstein SE, Levy RI (1982) National Heart, Lung, and Blood Institute Type II Coronary Intervention Study: Design, methods, and baseline characteristics. Controlled Clin Trials 3: 91–111Google Scholar
- 12.Buchwald H, Moore RB, Varco RL (1974) The partial ileal bypass operation in treatment of the hyperlipidemias. Adv Exp Med Biol 63: 221–230Google Scholar