The downward trend in cardiovascular mortality in the United States appears to be real and highly significant. Since most cardiovascular diseases, particularly coronary heart disease, appear to be multifactorial, no simple or single cause for this favorable trend can be advanced. As Kannel points out in an article in this issue of The Journal (p 877), there are no data about the incidence or severity of the disease, yet it would seem that here, too, there has been a favorable trend. In any event, these trends are important to the practitioner, for they affirm the hypothesis that atherosclerosis is not inevitable, as a result of age or genetic background, but preventable.
The challenge to the practitioner, then, is to participate actively in intervention against the factors known to be related to acceleration of the process. These have recently been summarized by the American Heart Association.1 Although definitive proof that
Schoenberger JA. The Downward Trend in Cardiovascular Mortality: Challenge and Opportunity for the Practitioner. JAMA. 1982;247(6):836. doi:10.1001/jama.1982.03320310084046
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