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February 9, 1957


JAMA. 1957;163(6):445-450. doi:10.1001/jama.1957.82970410004010

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Coronary atherosclerosis occurs to some extent almost universally in human beings. It is now the leading cause of death in persons past middle life in the United States. Significant coronary artery disease is found much earlier and in a more severe form in men than in women. Coronary atherosclerosis is also more pronounced in association with conditions in which hypercholesteremia is present, such as diabetes and hypothyroidism. Undoubtedly a constitutional trait predisposes certain families, and possibly certain racial stocks, to premature coronary atherosclerosis although the latter has not been proved. To what extent the physical and emotional stresses of life influence the development of this disease has not yet been discovered. Most cardiologists, however, are of the opinion that coronary insufficiency, as manifested either by pain or by myocardial failure, may be hastened by such stresses. The clearest example of this is the precipitation of attacks of angina pectoris by

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