Abstract

Since the landmark 1961 publication from the Framingham Study identifying smoking as a modifiable cardiac risk factor,1 the field of preventive cardiology has burgeoned, and the science of risk factor analysis 2 has been applied to other chronic diseases. Of most interest is the identification of risk factors that are not only predictive of disease but are also both modifiable and causal: for the example of cardiovascular disease (CVD), gender is predictive, but non-modifiable; homocysteine levels are predictive, modifiable, but not necessarily causal; and hypertension is predictive, modifiable, and causal, in that treatment reliably reduces the risk of disease.

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