Few physicians believed that cholesterol was a major factor in the development of atherothrombosis. Supportive evidence was based mainly on investigations in choles-terolfed, hypercholesterolemic rabbits that showed the development and progression of atheroma formation relative to the elevation in blood cholesterol. Anecdotal reports and small clinical studies supported this notion.
• The Seven Countries Study included more than 12,000 men from Finland, Greece, Italy, The Netherlands, Japan, the United States, and Yugoslavia. The Finns had the highest intake of saturated fat, the highest blood cholesterol levels (greater than 280 mg), and the high¬est number of fatal and nonfatal heart attacks, about 900 per 100,000. The Japanese, with an average blood cholesterol of 140 mg, had the lowest heart attack death rate of 102 per 100,000. The United States, with an average of 220 mg, had a heart attack death rate of 670 per 100,000. The death rate was also low in Greece and Italy. Japanese immigrants to the United States who adopt an American diet have an incidence of coro¬nary artery disease ten times that of their countrymen in Japan.
• The Framingham epidemiologic studies contributed good evidence to support the view that a high blood cholesterol greatly increases the risk of developing coronary artery disease.

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