Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Our data showed that the common belief
that only 50% of patients with CHD have at least 1 of the major CHD risk factors
(smoking, elevated blood pressure or cholesterol levels, and diabetes) is
incorrect. Our goal in reporting these findings was to aid in dispelling the
50% notion, certainly not to replace that myth with any other, as Drs Root
and Cobb suggest.
It is well known that the traditional risk factors have a dose-dependent
relationship with the risk of CHD.1 Thus,
while levels of smoking, blood pressure, and cholesterol in excess of physiologically
ideal values do not guarantee that exposed individuals will experience CHD,
the lack of specificity of the risk factors in producing CHD should not necessarily
lead to the conclusion that there are "still large gaps in the understanding
of the causes" of CHD.
Greenland P. Traditional Risk Factors for Coronary Heart Disease—Reply. JAMA. 2004;291(3):299. doi:10.1001/jama.291.3.300-b