Views & Reviews From the Frontline

Vascular disease: an amateur observation

BMJ 2010; 341 doi: (Published 22 September 2010) Cite this as: BMJ 2010;341:c5196
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

    Medicine wants to take the credit for the steep decline in vascular disease through the management of “risk factors.” But the constant gradient of decline since 1950 cannot be explained away in these terms, because such medical intervention began in earnest only in the early 1990s. Also, a litany of unexplainable paradoxes remains. For example, in France the death rate from vascular disease is a quarter of that in the United Kingdom, but France has higher rates of smoking and commensurate cholesterol and blood pressure profiles. UK citizens of south Asian origin …

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