Alterations of Factors Predisposing to Coronary Heart Disease

Habits, Physical and psychological factors, and biochemical abnormalities associated with an increased risk of coronary heart disease are discussed. There is no conclusive proof that correction of such factors prevents or delays the development of overt coronary heart disease, but the inferential evidence is impressive. Physicians and all persons interested in public health should enthusiastically advocate cessation of smoking, the maintenance of a lean body weight, and regular physical exercise. Compliance is safe, cheap, and noncontroversial. Beyond alterations in habits, the physician should strive for the early identification and correction of hypertension, hyperlipemia, and diabetes mellitus among his patients. The principles of treatment are discussed, but rigid and dogmatic recommendations are purposely avoided. Treatment must be flexible enough to fulfill the needs of patients with a variety of abnormalities that in some instances do not respond as expected to an apparently appropriate regimen.