Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Khot and colleagues1 found that 80% to 90% of patients with coronary
heart disease (CHD) have at least 1 of the 4 conventional risk factors, (ie,
cigarette smoking, diabetes, hyperlipidemia, and hypertension). The authors
thus suggested that these 4 risk factors should be emphasized to address the
epidemic of coronary heart disease (CHD). Similarly, Dr Greenland and colleagues2 found that at least 87% of individuals with either
fatal or nonfatal CHD had exposure to at least 1 of these 4 risk factors.
Neither group of authors, however, discussed the high prevalence of these
risk factors among individuals who did not develop CHD. Those who develop
CHD are, in fact, similar to the general population in terms of these risk
factors, as the data of Greenland et al indicate.
Rockhill B. Traditional Risk Factors for Coronary Heart Disease. JAMA. 2004;291(3):299. doi:10.1001/jama.291.3.299-a