Glucose tolerance, plasma lipids and atherosclerosis.

Introduction The problem of atherosclerosis is one of great complexity. Clinically we are concerned with an end result arterial obstruction which is the resultant of a multitude of precursor mechanisms, some external, some internal, many of them interdependent and interacting. We may start with our particular area of study, but if we follow it through, it will often become confluent with others starting elsewhere. Even when all the mechanisms are identified it will require computer techniques to describe the interplay of all the variables. In the face of this ‘multifactorial’ complexity the clinician may lose heart, but should not, for it is likely that these many ‘causes’ converge and produce their ‘effect’ by way of only a few final pathways. We should certainly continue to try to identify and correct main causal mechanisms, but we can also hope to prevent or modify the disease by manipulation of the final pathways.