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Risk factors revisited.

There is growing and increasingly firm evidence that certain remediable risk factors predispose to coronary artery disease. The most important of these appear to be systolic hypertension, cigarette-smoking, elevated blood lipids and glucose intolerance. When electrocardiographic left ventricular hypertrophy is also detected, a considerable further element of risk is imposed. Left ventricular hypertrophy and cigarette-smoking may predispose to sudden death. Tables are now readily available for assigning each patient a factor, and physicians can place their patients on an active program to reduce risk factors and possible to prevent development of coronary artery disease. Despite lack of absolute proof that such programs will be efficacious, the information presently available to us suggests that this represents a prudent approach to preventive therapy of this major international health problem.