Stehbens W E
Department of Pathology, Wellington School of Medicine, New Zealand.
Med Hypotheses. 1995 Nov;45(5):449-54. doi: 10.1016/0306-9877(95)90219-8.
Accurate usage of the term 'epidemic' is important scientifically and it should ideally be used to mean only contagious diseases, not used loosely or emotively to mean non-infectious diseases, particularly coronary heart disease, which is a non-specific complication of many diseases. It should not be used as a surrogate term for atherosclerosis of indefinite severity. An epidemic of atherosclerosis is impossible, there being no variation in prevalence because the disease is ubiquitous. Moreover, vital statistics are too unreliable to determine the existence of an increase or decline in coronary heart disease. A coronary heart disease epidemic could be due to an increase in non-atherosclerotic coronary heart disease or increased severity of atherosclerosis. The former has not been studied and the latter would cause a shift to the left in age distribution and is inconsistent with the fall in 'all cause' and stroke mortality rates whilst coronary heart disease mortality allegedly increased alarmingly. A coronary heart disease epidemic, having no scientific basis, negates any reason for the sustained search for a speculative causative environmental factor.
准确使用“流行病”一词在科学上很重要，理想情况下，它应仅用于表示传染病，而不应被宽泛或情绪化地用于表示非传染性疾病，尤其是冠心病，它是许多疾病的非特异性并发症。它不应被用作表示严重程度不确定的动脉粥样硬化的替代术语。动脉粥样硬化的流行是不可能的，因为这种疾病无处不在，患病率没有变化。此外，生命统计数据过于不可靠，无法确定冠心病是增加还是减少。冠心病的流行可能是由于非动脉粥样硬化性冠心病的增加或动脉粥样硬化严重程度的增加。前者尚未得到研究，而后者会导致年龄分布向左偏移，这与“全因”死亡率和中风死亡率下降而冠心病死亡率据称惊人增加的情况不一致。冠心病的流行没有科学依据，否定了持续寻找推测性环境致病因素的任何理由。
