Logic dictates that for scientific progress in atherogenesis "cause" must b
e the sole prequisite without which the disease cannot occur. Nor can it be
assumed that statistical associations (risk factors) with coronary heart d
isease (CHD) are causal for atherosclerosis and extrapolations from correla
tions with CHD incidence to atherosclerosis are invalid. Any factor conside
red to play a role in atherogenesis requires pathological and experimental
evidence consistent with the logic of Koch's specificity of cause and effec
t. Current epidemiological misuse and manipulation of cause and risk factor
s are contrary to the basic precepts of scientific logic and the fundamenta
l need for precision in word usage. The term "risk factor", because of the
current deeply entrenched false concept of causality has retarded medical p
rogress and should be abandoned. Its adherents, guilty of a disservice to t
he tenets of their discipline, have also sullied the scientific integrity o
f medicine as a whole.