ABSTRACT
The emergence of coronary heart disease as a major cause of death at midcentury in the United States led to intense speculation as to its causes. The chapter describes changes in risk factors during the emerging phase of the pandemic. Risk factors for pandemic coronary heart disease differed from those for normal coronary heart disease before the pandemic. A set of important risk factors for coronary heart disease was specified in 1990 by the United States Department of Health and Human Services for its Healthy People program, which established objectives for the health of the American population in 2000. Measuring the impact of specific risk factors on coronary heart disease during the height of the pandemic must consider the basic characteristics of all risk factors. The "diet-heart hypothesis" holds that patterns of food consumption are key risk factors for coronary heart disease, especially foods containing dietary cholesterol and saturated fats.
