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ARTICLE |

An Analysis of the Causal Factors of Atherosclerosis

EDWIN F. HIRSCH, M.D.
AMA Arch Intern Med. 1958;102(6):1024-1035. doi:10.1001/archinte.1958.00260230170021.
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Atherosclerosis of the aorta and of its main arterial branches ranks high among the causes of natural death in man. Although the records and observations of atherosclerosis in man and in lower animals extend far into antiquity, no generally accepted cause for the evolution of the disease has been proposed. Opinions expressed recently4,5 offer the hypothesis that diets rich in animal fats have a causal relation to atherosclerosis in man. The implied impact of this fat-rich diet on the arterial tissues is through the lipids in transport in the blood and from which the lipids in the fatty plaques of the intima are derived.

Some regard the lesions of atherosclerosis as part of an aging process; others think that they are caused by lipid infiltrations of the intima and result from disorders of lipid metabolism.2 Each view alone is confronted with pertinent objections. The one view emphasizes a

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