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Aaron R. Folsom, MD

JAMA. 1999;281:461-462.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Atherosclerotic cardiovascular disease is the leading cause of death in the United States and, by 2020, is projected to be the leading cause of disability in the world.¹ Many important and preventable risk factors for atherosclerotic disease have been identified, including hypercholesterolemia, hypertension, cigarette smoking, diabetes, obesity, and physical inactivity. Nevertheless, additional environmental factors probably contribute to the initiation, propagation, and rupture of atherosclerotic plaques, and, ultimately, to clinical atherothrombotic events. The possibility that infection may be one of these factors was hypothesized more than 100 years ago²—a hypothesis that has attracted renewed scientific interest recently.

Epidemiological, basic, and clinical investigations during the past decade have suggested, but not yet proven, that infectious agents may in fact contribute to atherosclerotic vascular disease. The organisms implicated most often include the herpesviruses, particularly cytomegalovirus, Chlamydia pneumoniae, and, less convincingly, Helicobacter pylori.^3-4 Periodontitis also has been . . . [Full Text of this Article]

Author Affiliation: Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis.

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