Seftel H C
S Afr Med J. 1978 Jul 15;54(3):99-105.
Coronary heart disease (CHD) remains an uncommon disorder in the South African Black population. It has been suggested that herein lies an enigma, since it is believed that these people are considerably exposed to the conventional risk factors for CHD. To test this belief I have assessed the exposure of Black people, in time and degree, to the following CHD risk factors: affluence, age, hypertension, hyperlipidaemia, dietary excess, smoking, physical inactivity, diabetes, obesity, hyperuricaemia and hyperinsulinism. Among males only hypertension, and among females only hypertension and obesity, emerged as prominent factors. However, neither of these is significantly atherogenic in the social, nutritional and metabolic milieu in which Blacks generally live, and obesity is a doubtful atherogenic factor, even in westernized populations. It is therefore concluded that the rarity of CHD in Blacks is not enigmatic, but is appropriate to their environmental circumstances.
冠心病（CHD）在南非黑人人群中仍然是一种不常见的疾病。有人认为这是一个谜，因为人们认为这些人大量暴露于冠心病的传统危险因素中。为了验证这一观点，我评估了黑人在时间和程度上对以下冠心病危险因素的暴露情况：富裕程度、年龄、高血压、高脂血症、饮食过量、吸烟、缺乏体育活动、糖尿病、肥胖、高尿酸血症和高胰岛素血症。在男性中，只有高血压是突出因素；在女性中，只有高血压和肥胖是突出因素。然而，在黑人普遍生活的社会、营养和代谢环境中，这些因素都没有明显的致动脉粥样硬化作用，即使在西方化人群中，肥胖也是一个可疑的致动脉粥样硬化因素。因此可以得出结论，黑人中冠心病的罕见并非神秘莫测，而是与其环境状况相适应的。
