The early history, the nature and the
incidence of coronary atherosclerosis and
ischaemic heart disease have been reviewed.
Evidence has been presented to suggest that there
are aetiological factors which favour the development
of ischaemic heart disease without influencing
the incidence of coronary atherosclerosis.
The close relationship of cholesterol
metabolism to coronary atherosclerosis and to
ischaemic heart disease has been emphasised.
The circulating lipids and lipoproteins
have been studied in health in relation to age
and sex. They were abnormal in the majority
of patients with ischaemic heart disease,
particularly in those under the age of 50.
Analysis of the circulating lipids and lipoprotein
could aid the solution of an equivocal diagnosis
in young subjects suspected of having ischaemic
heart disease.
The effects of endogenous hormones and
the action of administered hormones on the
circulating lipids and lipoproteins have been
described in detail. Hormones can also
influence the fluid state of the blood and the
tonicity and metabolism of arteries. It has
been postulated that the homeostasis of cholesterol
metabolism, of the fluid state of the blood
and of arterial metabolism could be disturbed
by alteration of the physiological endocrine
balance.
The thesis has been proposed that an
endocrine imbalance could contribute to the
development of coronary atherosclerosis and of
ischaemic heart disease. The relationship of
this thesis to existing theories of the aetiology
of ischaemic heart disease has been considered
in detail.
Finally, some therapeutic implications of
these metabolic and endocrine aspects of coronary
disease have been considered
