COMMENTARY

Further Analysis of INTERHEART: What Do the Data Tell Clinicians?

Arya Sharma, MD

Disclosures

January 19, 2006

In This Article

Introduction

Readers of Medscape CARDIOLOGY are certainly aware of the magnitude of the burden of cardiovascular disease (CVD) that challenges humankind. However, at the same time, perhaps because this challenge has been recognized for so long, many of us in the worldwide medical community have accumulated certain beliefs about this disease that have remained surprisingly untested. For example, it has generally been thought that CVD in North Americans must be different in at least certain aspects from the same disease when it occurs in, eg, Japanese or Egyptians. Additionally, CVD seems to be a complex disease, with only about half of the factors that explain its causes and outcomes really known. In other words, there might be many other etiologic factors (eg, epithelial components, adhesion molecules) that are yet to be discovered. These assumptions have no doubt been reinforced by the fact that our knowledge about risk factors for CVD has been largely derived from studies in the developed countries, and applicability of these results to other populations was largely unknown.

On this background, 2 broad questions can be asked that will serve to put the overall worldwide challenge of CVD into perspective:

  1. Does the etiology of CVD vary significantly across cultures?

  2. What principal factors are most predictive of the occurrence of CVD?

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