Editorials

Aetiology of coronary heart disease

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7324.1261 (Published 01 December 2001) Cite this as: BMJ 2001;323:1261

Fetal and infant growth and socioeconomic factors in adult life may act together

  1. Michael Marmot (m.marmot@ucl.ac.uk), professor
  1. International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, London WC1E 6BT

    Papers p 1273

    It is a common tendency in science to argue that in order for my pet hypothesis to be correct yours has to be wrong. Indeed, it is somewhat unsatisfying for both yours and mine to be right at the same time. Barker's work on the fetal and infant origins of coronary heart disease has stimulated such reactions.1 The two positions are that coronary heart disease is determined by factors associated with growth in utero or in the first year of life or that it is caused by social conditions and lifestyle acting later in life. Among the arguments for the former is the body of work that Barker and colleagues have produced over 15 years.2 Arguing for the importance of contemporaneous influences is that coronary heart disease rates can be reduced within five years by reducing cholesterol levels,3 giving up smoking,4 or reducing blood pressure levels.5 Rates of coronary heart disease are strongly related to social class6 and changed rapidly …

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