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October 23, 1972

Manifestations of Atherosclerosis

JAMA. 1972;222(4):488. doi:10.1001/jama.1972.03210040056024

To the Editor.—  The report by Gordon and Kannel in the Aug 14,1972, issue of The Journal indicating common precursors for the three major manifestations of atherosclerosis fills an important gap in our knowledge of the relationship between peripheral vascular, cerebrovascular, and coronary atherosclerotic disease.I question whether these risk factors are really applicable in the older age groups. Gordon and Kannel note that the relationship of cigarette smoking and cholesterol to coronary heart disease does not hold in the age group 65 to 74. In a retrospective study1 of elderly patients at the Veterans Administration Hospital, Dr. Ritzmann and I noted a strong association between peripheral vascular atherosclerotic disease and coronary heart disease. However, not all of the usually cited risk factors for coronary heart disease seemed to apply to these elderly war veterans. Other studies2-4 have shown that the factors of obesity, serum cholesterol, and cigarette