Epidemiological risk factors of coronary heart disease are not causal in atherosclerosis.
Logic dictates that for scientific progress in atherogenesis "cause" must be the sole prequisite without which the disease cannot occur. Nor can it be assumed that statistical associations (risk factors) with coronary heart disease (CHD) are causal for atherosclerosis and extrapolations from correlations with CHD incidence to atherosclerosis are invalid. Any factor considered to play a role in atherogenesis requires pathological and experimental evidence consistent with the logic of Koch's specificity of cause and effect. Current epidemiological misuse and manipulation of cause and risk factors are contrary to the basic precepts of scientific logic and the fundamental need for precision in word usage. The term "risk factor", because of the current deeply entrenched false concept of causality has retarded medical progress and should be abandoned. Its adherents, guilty of a disservice to the tenets of their discipline, have also sullied the scientific integrity of medicine as a whole.
Stehbens
W E
WE
Department of Pathology and Molecular Medicine, Wellington School of Medicine, Wellington South, New Zealand. wstehbens@wnmeds.ac.nz
D001161:Arteriosclerosis / Q000209:etiology*; D003327:Coronary Disease / Q000209:etiology*; D004812:Epidemiologic Methods; D006801:Humans; D012307:Risk Factors