Diet in the epidemiology of coronary heart disease.

The term coronary heart disease (CHD) includes three distinct but overlapping syndromes in middle-age : myocardial infarction, angina pectoris, and sudden death. Virtually all CHD occurs on the basis of severe atherosclerosis, although not every person with severe atherosclerosis necessarily suffers from CHD. We are thus concerned to understand both the aetiology and pathogenesis of atherosclerosis, and the pathogenesis of CHD, which can be regarded as a complication of severe atherosclerosis. Fig. I depicts a hypothesis concerning CHD and in the main it presents the ‘nutritional-metabolic’ concept of atherosclerosis and CHD (Stamler, 1967). In this