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A more recent version of this article appeared on February 1, 2005

Papers In Press, published online ahead of print November 16, 2004
J. Lipid Res., doi:10.1194/jlr.R400012-JLR200
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Submitted on October 27, 2004
Revised on November 16, 2004
Accepted on November 1, 2004

Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy, part II: The early evidence linking hypercholesterolemia to coronary disease in humans

Daniel Steinberg

Medicine Dept., University of California San Diego, La Jolla, CA 92093-0682

Corresponding Author: dsteinberg{at}ucsd.edu

The first in this series of historical reviews dealt with the pioneering animal model work of Anitschkow, implicating blood cholesterol in the pathogenesis of atherosclerosis, and the pivotally important work of Gofman, providing evidence that blood cholesterol was also a major factor in the human disease. This second installment reviews the early lines of evidence linking hypercholesterolemia in humans to the progression of atherosclerosis and the risk of coronary heart disease. The case is made that by 1972 the evidence was already strong enough to justify intervention to lower blood cholesterol levels if all the available lines of evidence had been taken into account. Yet it would be almost two decades before lowering blood cholesterol levels became a national public health goal. Some of the reasons the “cholesterol controversy’ continued in the face of powerful evidence supporting it are discussed.


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