Hywel Davies, M.D., FRCP, FACC was a science undergraduate at Oxford University before service in the Royal Engineers in World War II, after which he returned to read medicine. After five years in general (internal) medicine he began his training in cardiology under Dr. S. Gilbert Blount Jr. in Denver and Dr. Paul Wood in London. He was honorary consultant at Guy’s Hospital and then joined the faculty of the University of Colorado as Chief of Cardiology at the Denver VA Hospital. He returned to Cambridge, England as cardiologist to the heart transplant unit at Papworth Hospital.2006 0-7734-5702-X
This book addresses the causes of coronary arterial disease. The inception of the intimal plaque is characterized essentially as the undue proliferation, for any of a number of reasons, of intimal cells, influenced by not only by genetic factors but by mitogens from the environment. There is little evidence of the participation of lipids during the initial stages, though this occurs later to varying degree.
There is good evidence that lesions may appear in the coronary arteries of infants and children, even to the point at times of calcium deposition in ‘normal’ subjects at birth. This, it is averred, points to the involvement of calcifying factors in the environment, notably Vitamin D, calcium and phosphorus. The central role played by intracellular and extracellular calcium is considered, particularly from the standpoint of their perturbation from environmental causes including infant feeding and chemical pollution.
The part played by calciphylaxis, in its original and derived meanings, is looked at with reference not only to end-stage renal disease but across a wider spectrum. The hazards of an environment replete with calcium, phosphorus and steroids are emphasized, while lipids are seen as having mainly an adjunctive rather than a causative influence on the evolution of coronary disease.
The current enthusiasm for increasing the intake of Vitamin D, calcium and phosphorus in the face of environmental surfeit is questioned as being in the best interests of public health.