The 50% Myth: Do we need new cardiovascular risk factors? The Myth: “ just 50% of CHD cases are explained by classical risk factors “ WRONG! Robert Beaglehole (2002) stated: Int J Epidemiol. 2002 Dec;31(6):1117-22 the source of this assertion is very difficult to discover evidence from existing studies shows that the classical risk factors explain most cases of CHD. concluded the search for new CHD risk factors is just occupational therapy for epidemiologists More recently, InterHEART, an international case-control study provided valuable data to use in this debate. The exercise: Please address these questions: What proportion of CHD burden could be attributed to diet and lifestyle risk factors? Justify your answer and support it from the strengths you identify in this study Consider the weaknesses that you identified in this paper, what other evidence you will need to support your conclusions? Methodology: Divide 4 groups. All groups starts with the abstract. Then groups will share out the sections, one group doing Introduction, one the Methods, Results [first three paragraphs , please focus on Table 3,4 and 5] OR Discussion. Use the critical appraisal skills checklist to help you decide on the quality of this case-control study and to summarize the main results.

 INTERHEART Study ”nine potentially modifiable risk factors account for over 90% of the risk of an initial acute myocardial infarction” Population attributable risk fractions Salim Yusuf et al . Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study). Lancet  364  9437   11 Sept 2004

INTERHEART Study CONCLUSIONS nine potentially modifiable risk factors account for over 90% of the risk of an initial acute myocardial infarction [AMI] Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity 9 risk factors account for most of AMI risk worldwide in both sexes and at all ages in all regions. prevention strategies can be based on similar principles worldwide and have the potential to prevent most premature AMIs Salim Yusuf et al . Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study). Lancet  364  9437   11 Sept 2004