La fréquence de la maladie coronaire en France et le "paradoxe français".

Abstract

Depuis cinquante ans, le développement des études épidémiologiques cardiovasculaires comparant les populations dans différents pays ont permis d’identifier certains déterminants du risque coronaire dans les populations humaines. Elles ont apporté des arguments supplémentaires aux connaissances cliniques et expérimentales et ont en outre permis de définir de nouveaux axes de recherche et de prévention. Certains pièges peuvent cependant exister comme le montre l’histoire du fameux « paradoxe français » rendu caduque par les résultats récents du projet MONICA.

Epidemiological research has demonstrated the importance of specific risk factors for coronary heart disease and improved the degree to which people at increased risk of the disease can be identified. One of the most important risk factor at the population level, the mean intake of dictary saturated fat, has been documented more than 20 years ago. The reported low mortality from coronary disease in France with a relatively high fat intake was considered as the 'French paradox'. It has been usually attributed to the higher consumption of alcohol in France. However caution was necessary because reliable data on coronary disease incidence were not fully available. The recent data from the MONICA Project which monitored coronary heart disease events over 10 years across 37 populations in 21 countries, clearly demonstrate that rates of coronary disease in France are of the same order as those in Southern Europe, to which it belongs geographically. The 'French paradox' has just foundered and the interesting question is now why coronary heart disease is less prevalent in Southern than Northern Europe.