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June 17, 1968

Prevention of Ischemic Heart Disease: Principles and Practice

JAMA. 1968;204(12):1150. doi:10.1001/jama.1968.03140250130032

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Based on material presented at the First International Conference on Preventive Cardiology (1964), this book deals with pathophysiologic, epidemiologic, preventive, and educational aspects of hypoxic heart disease. Avoiding atherosclerosis, it stresses nonvascular, humoral, and neurogenic etiologic factors, which increase myocardial vulnerability to vagaries of blood supply. Emphasis is placed on catecholamines, which damage the myocardium by interfering with oxygen consumption. Their stimulation by nicotine and emotional stress and their inhibition by muscular activity account for the former's adverse effects and the latter's benefits. Support for this concept derives from experimental studies and from epidemiologic surveys which highlight the rarity of myocardial hypoxia in hard-working, nonsmoking, stress-free population groups, and its frequency in their hard-driving, tense, physically inactive opposites.

Emphasizing organized physical training programs for prevention and rehabilitation in ischemic heart disease, the book urges their wide adoption. It calls upon health institutions, medical colleges, and physicians to teach the value