Case Report
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World J Cardiol. Jan 26, 2011; 3(1): 40-42
Published online Jan 26, 2011. doi: 10.4330/wjc.v3.i1.40
Central obesity, hypertension and coronary artery disease: The seed and soil hypothesis
Shridhar Dwivedi, Amitesh Aggarwal
Shridhar Dwivedi, Amitesh Aggarwal, Department of Medicine/Preventive Cardiology, University College of Medical Sciences, University of Delhi and GTB Hospital, Delhi 110095, India
Author contributions: Dwivedi S and Aggarwal A contributed equally to this work, including analyzing the data and designing and writing the paper.
Correspondence to: Dr. Shridhar Dwivedi, Professor, Head, Department of Medicine/Preventive Cardiology, University College of Medical Sciences, University of Delhi and GTB Hospital, Delhi 110095, India. shridhar.dwivedi@gmail.com
Telephone: +91-11-22586262-2507 Fax: +91-11-22590495
Received: October 11, 2010
Revised: January 7, 2011
Accepted: January 14, 2011
Published online: January 26, 2011
Abstract

Coronary artery disease (CAD) is a multifactorial disease wherein hereditary and environmental factors play a major role. Our hypothesis is that an individual’s genetic profile functions as soil while various environmental factors such as physical inactivity, smoking, stress, etc. act as seeds in the etiopathogenesis of CAD. Much of the information regarding genetic and environmental factors can be determined in a pedigree chart by taking a history of the index patient, including details of major risk factors such as age, sex, smoking, hypertension, diabetes, coronary artery disease and stroke in the family. Preparing such a chart is a cost-effective way of initiating primary preventive measures in patients in a developing economy. The advantage of a detailed pedigree chart is to provide a snapshot view of the evident and underlying risk factors in the family as a whole, and not to merely study conventional risk factors. It elucidates the hidden stressors and hereditary factors responsible for cardiovascular disease in the family. We report herein an illustrative pedigree chart which exemplifies our above hypothesis.

Keywords: Pedigree chart; Coronary artery disease; Seed and soil