Cholesterol, Atherosclerosis and Coronary Disease in the UK, 1950–2000.
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Cholesterol began to be accepted after the Second World War as a significant cause of atherosclerosis and associated conditions such as coronary heart disease (CHD). This Witness Seminar, chaired by Professor Michael Oliver, included a discussion of the basic research on cholesterol. Early epidemiological studies demonstrated the relationship between excess saturated fat consumption and elevated levels of cholesterol, although cholesterol alone did not explain all population differences. Work on lipoprotein metabolism pointed to hypercholesterolaemia as one of, if not the major, risk factors for CHD, culminating in the development of cholesterol-lowering drugs, particularly the successful statins, available in the UK from the 1980s, and confirmed by randomized controlled trials. The role of diet in heart disease had always been controversial in the UK, and although extreme diets could reduce cholesterol, patient conformity remains difficult. Later, recommended limits on the composition of dietary fat were agreed, assisted by the food industry's introduction of functional foods such as cholesterol-lowering margarine. An introduction by Dr Nick Myant and appendices, on the diet-heart hypothesis by Professor Gerry Shaper and the development of lovastatin by Dr Jonathan Tobert, compliment the transcript. Contributors include Professor David Barker, Professor John Betteridge, Professor Gustav Born, Professor Richard Bruckdorfer, Professor George Davey Smith, Professor Paul Durrington, Professor David Galton, Dr Arthur Hollman, Professor Steve Humphries Professor Gordon Lowe, Professor Vincent Marks, Dr Paul Miller, Professor Jerry Morris, Professor Chris Packard, Professor Stuart Pocock, Professor Kalevi Pyörälä, Professor Thomas Sanders, Professor James Scott, Dr Elspeth Smith, Professor Anne Soutar, Professor Gilbert Thompson, Professor Hugh Tunstall-Pedoe, Professor Neville Woolf and Professor John S Yudkin. Reynolds L A, Tansey E M. (eds) (2006) Cholesterol, atherosclerosis and coronary disease in the UK, 1950–2000, Wellcome Witnesses to Twentieth Century Medicine, vol. 27. London: The Wellcome Trust Centre for the History of Medicine at UCL.