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Debunking the "Only 50%" Myth

John G. Canto, MD, MSPH; Ami E. Iskandrian, MD

JAMA. 2003;290:947-949.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Conventional wisdom (or misconception) holds that the 4 major modifiable traditional cardiovascular risk factors—smoking, diabetes mellitus, hypertension, and hypercholesterolemia—account for "only 50%" of those who go on to develop coronary heart disease (CHD),^1-2 even though the original source of this claim is not well documented. Thus, over the past decade, a search to discover novel markers and other nontraditional risk factors to assess cardiovascular risk has come to the forefront.

In 2 separate articles in this issue of THE JOURNAL, Khot et al³ and Greenland et al⁴ examined data from 14 randomized clinical trials (n = 122 458) and 3 observational studies (n = 386 915), respectively, and directly challenge this "only 50%" claim. The investigators report that 80% to 90% of patients who developed clinically significant CHD and more than 95% of patients who experienced a fatal CHD event in fact . . . [Full Text of this Article]

Author Affiliations: Chest Pain Center, Division of Cardiovascular Diseases, University of Alabama at Birmingham.

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