John C. Cassel memorial symposium

.J Chron Dis Vol. 33, p 261 Pergamon Press Ltd 1980. Pnnted

in Great

Britam

Editorial

JOHN

C. CASSEL MEMORIAL H. A.

Department

SYMPOSIUM

TYROLER

of Epidemiology, Rosenau Hall 201H, University Chapel Hill, NC 27514, U.S.A.

of North

Carolina,

THIS

issue of the Journal of Chronic Diseases contains an Evans County Heart Disease Symposium dedicated to Dr. John C. Cassel. The Evans County Heart Study was designed as an epidemiologic investigation in a total community to test the clinical impression of Dr. Curtis G. Hames, based on his medical practice, of a relative deficit of coronary heart disease in Evans County blacks despite their marked excess of hypertension. Population-based observations beginning in 1960 have confirmed the clinical impression. The first series of studies was summarized by Cassel [l]. They demonstrated that the same known, strong, biological risk factors of elevated blood pressure, elevated total serum cholesterol and smoking were operative in Evans County, as elsewhere. However, white males had higher coronary heart disease incidence than black males at comparable levels of these risk factors. There was a gradient of coronary heart disease prevalence increasing from black to white lower social class, to white upper social class men in 1960. The incidence rates of coronary heart disease between 1960 and 1967 did not disclose a gradient by social class among whites, suggesting local changes in Evans County similar to those related to adaptation to the modernization and urbanization process going on worldwide. Further investigations suggested that some of the black-white and socialclass differences in coronary heart disease might be attributable to differences in physical activity. The current series of studies newly reported in this symposium are directed towards the following: the investigation of additional coronary heart disease risk factors in Evans County, such as the role of serum triglycerides and diabetes; possible mechanisms responsible for the observed black-white differences in coronary heart disease susceptibility, such as fibrinolytic and dopamine-/&hydroxylase activity; the relationship of serum cholesterol levels to the incidence of cancer; and the possible cultural as well as genetic inheritance of serum cholesterol levels in Evans County. Dr. John C. Cassel, a major figure in contemporary epidemiology, collaborated with Dr. Curtis G. Hames in the design and conduct of the Evans County studies and was singularly instrumental in the conceptual approach to this program of investigation. He was particularly dedicated to the synthesis of the theories and methods of the social sciences with those of the biomedical sciences in epidemiologic research. His untimely death in 1976 deprived the world public-health community of one of its leading scholars. This loss is particularly felt in the Evans County Project; however, his academic and research influence continues through his writings, the impact of his teaching efforts, and most importantly, the personal example of his life and work. The papers in this symposium are dedicated to him as a continuation of the work he initiated.

REFERENCE

I. Cassel JC: Summary

of major

findings

of the Evans County 261

cardiovascular

studies.

Arch Int Med 128: 1971