Pathogenesis of Coronary Atherosclerosis

In the United States between 1974 and 1977, 52% of all causes of death were attributed to cardiovascular diseases {l}. By 1981 and 1982 this figure declined slightly to 49%. Since 1974 ischemic heart diseases have accounted for approximately 65% of all cardiovascular diseases and were responsible for every third death in the United States during this period. The purported increase in the incidence of ischemic heart disease in civilized communities during the first two thirds of this century has been attributed variously to the decline and/or extinction of infectious disease, to a “less than optimal adaptation to changing patterns of lifestyle,” and to advances in diagnostic techniques. Although the mortality rate for ischemic heart disease in the United States has declined significantly (24%) since 1963 {1–3}, its incidence has not, and this entity remains the cause of more deaths in the United States than any other disease.