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Cited by 702Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Health and Risk Factors

The DOI matches its Crossref record; 87 of the 88 references it cites were found in a registry or an index.

Epidemiology as a Guide to Clinical Decisions: The Association between Triglyceride and Coronary Heart Disease

Hulley, Stephen B., Rosenman, Ray H., Bawol, Richard D., Brand, Richard J.·1980·New England Journal of Medicine
DOI 10.1056/nejm198006193022503
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Abstract

The hypothesis that triglyceride is a cause of coronary heart disease, although unconfirmed and never universally accepted, has nonetheless strongly influenced the practice of preventive medicine. We have examined the epidemiologic association between triglyceride and coronary heart disease to evaluate the validity of inferring that there is a causal relation between the two. Neither the evidence from published studies nor an analysis of data from the Western Collaborative Group Study provides strong support for the causal hypothesis. Information from other scientific disciplines is also meager, contrasting with the coherence of diverse evidence supporting the hypothesis that cholesterol is a cause of coronary heart disease. These arguments fall short of disproving the belief that lowering triglyceride will prevent coronary heart disease, especially since triglyceride and cholesterol are inextricably associated through mutual lipoprotein carriers. But we propose that the ethics of preventive medicine place the burden of proof on the proponents of intervention. We therefore recommend that widespread screening and treatment of healthy persons for hypertriglyceridemia be abandoned until more persuasive evidence becomes available.

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Research works printed but not linked: 11

  1. Hayes, 1964, Clin Sci, 26, 185
  2. Rhoads, 1978, Lab Invest, 38, 304
  3. Bierman EL. Atherosclerosis and other forms of arteriosclerosis. In: Isselbacher KJ, Adams RD, Braunwald E, Petersdorf RG, Wilson JD, eds. Harrison's principles of internal medicine. 9th edition. New York: McGraw-Hill, 1980:1156–66.
  4. Cornfield, 1959, Am J Ment Defic, 64, 240
  5. Grundy, 1978, West J Med, 128, 13
  6. McGill HC. Atherosclerosis: problems in pathogenesis. In: Paoletti R, Gotto AM, eds. Atherosclerosis Reviews. Vol. 2. New York: Raven Press, 1977; 2:27–65.
  7. Vil, 1978, N Engl J Med, 298, 109
  8. 10.1001/jama.231.4.360 · DOI
  9. McKeown T. Unvalidated procedures have no place in screening programs. In: Ingelfinger FJ, Ebert RV, Finland M, Relman AS, eds. Controversies in internal medicine II. Philadelphia: WB Saunders, 1974:92–8.
  10. University Group Diabetes Program, 1970, Diabetes, 19, 785
  11. University Group Diabetes Program, 1975, Diabetes, 24, 65

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Metadata

Authors
Hulley, S. B., Rosenman, R. H., Bawol, R. D., & Brand, R. J.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1980-06-19
Volume
302
Issue
25
Pages
1383-1389
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm198006193022503
OpenAlex
W1989258056
Cited by
702
References
88
Citations by year
2025: 4 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 7 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 4 · 2016: 7 · 2015: 9 · 2014: 8 · 2013: 7 · 2012: 11
FWCI
53.22
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords
triglycerides, coronary artery disease, hypertriglyceridemia, causal inference, cholesterol, preventive medicine, burden of proof, screening, lipid-lowering therapy, clinical decision-making
MeSH terms
Adult, Cholesterol, Coronary Disease, Decision Making, Epidemiologic Methods, Ethics, Medical, Health Policy, Humans, Middle Aged, Retrospective Studies, Risk, Triglycerides

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