Further Information

A survey of 246 Suggested Coronary Risk Factors | Paul N. Hopkins, Roger R. Williams
Article Published: 1981

Type: Articles and Dissertations
Published By: Atherosclerosis, 40 (1981) 1-52

Further Information

“Studies of coronary heart disease (CHD) have led medical investigators to suggest an association with CHD for at least 246 factors. Though cause and effect relationship have not been demonstrated for the vast majority, consideration of these factors provides clues to CHD etiology and insight into possible preventive measures.”

“In the strictest sense, a ‘risk factor’ for CHD should be associated with the disease and be demonstrated to have the ability to help predict the probability of CHD emergence following given measured levels of the factor. To demonstrate this relationship requires a prospective study. Factor levels are initially measured and correlated with subsequent frequency of CHD incidence or mortality. Causality can only be proven by intervention trials. Nevertheless, even according to strict definitions, a risk factor may not be causal. For example, speaking English or Finnish is predictive of an increased risk of CHD and hence a risk factor. The language per se does not promote CHD but likely reflects associated environmental or genetic factors that play a causal role leading to greater occurrence of CHD.”

“Perhaps because of the enthusiasm displayed by investigators searching for means to control or prevent CHD, the term ‘risk factor’ has been popularized to include factors associated with CHD only in retrospective case-control studies, laboratory and animal experiments, or even merely suggested on theoretical grounds.

Yet, the mass-media and antitobacco propaganda continue to lead us to believe that, were active and passive smoking be removed and diet absolutely controlled, we would see a huge decrease of these diseases because smoking and diet "cause" heart disease.

Read the long list of suspected factors starting at page 9 of this document and see for yourself. How can any doctor know that his patient’s heart attack was caused by smoking? Simply put, he cannot. He can only guess, and imagine. Guesses and imagination turn into opinions, and opinions then are painted as scientifically demonstrated causality. As it is for cancer and another large number of multifactorial diseases, establishing causality is not easy – and often it may be not be possible at all.

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