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February 1968

The Enigma of Coronary Heart Disease.

Arch Intern Med. 1968;121(2):194. doi:10.1001/archinte.1968.03640020082021

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The enigma of coronary heart disease is not solved by this monograph. But as the author states, one can only get the correct answers by asking the correct questions. The author is a distinguished pathologist and sophisticated statistician who analyzes morbidity and mortality data with particular reference to ischaemic heart disease in this monograph. The analysis of the various hypotheses in regard to the etiology of ischaemic heart disease are shown by him to be replete with error; statements such as the "modern epidemic of coronary heart disease" reflect loose thinking. His analysis of the data for England and Wales indicates that the deaths which in the early part of the century were attributed to senility and ill-defined heart disease have in the later decades been attributed to ischaemic heart disease. Accordingly, the increase in the age-specific death rate for coronary artery disease is more likely a consequence of change

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