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January 10, 1986

Prevention of Coronary Heart Disease in Practice

Author Affiliations

American Health Foundation New York

JAMA. 1986;255(2):199-200. doi:10.1001/jama.1986.03370020041020

To the Editor.—  Those working in the area of coronary heart disease prevention read the contribution of Dr Borhani1 with great interest. The article entitled "Prevention of Coronary Heart Disease in Practice," well summarizes the various intervention trials. There is general agreement that prevention has played an important role and can, if properly applied, have even greater impact on the incidence of coronary artery disease. There is not agreement, however, that in terms of primary prevention, a physician's medical intervention should be limited to the identification of high-risk children or first-degree relatives of patients with established heart disease. Decades ago, Virchow observed that "crowd diseases" by and large do not have a genetic basis but relate to a common factor affecting a sizable proportion of a population. Clearly, this concept applies to coronary artery disease and atherosclerosis. Determining blood lipid levels in children is important not only because so