Elsevier

The Lancet

Volume 328, Issue 8513, 25 October 1986, Pages 933-936
The Lancet

SERUM CHOLESTEROL, BLOOD PRESSURE, AND MORTALITY: IMPLICATIONS FROM A COHORT OF 361 662 MEN

https://doi.org/10.1016/S0140-6736(86)90597-0Get rights and content

Abstract

The risks associated with various levels of serum cholesterol were determined by analysis of 6-year mortality in 361 662 men aged 35-57. Above the 20th percentile for serum cholesterol (> 181 mg/dl, >4·68 mmol/l), coronary heart disease (CHD) mortality increased progressively; the relative risk was large (3·8) in the men with cholesterol levels above the 85th percentile (>253 mg/dl, > 6·54 mmol/l). When men below the 20th cholesterol percentile were used as the baseline risk group, half of all CHD deaths were associated with raised serum cholesterol concentrations; half of these excess deaths were in men with cholesterol levels above the 85th percentile. For both CHD and total mortality, serum cholesterol was similar to diastolic blood pressure in the shape of the risk curve and in the size of the high-risk group. This new evidence supports the policy of a moderate fat intake for the general population and intensive treatment for those at high risk. There is a striking analogy between serum cholesterol and blood pressure in the epidemiological basis for identifying a large segment of the population (10-15%) for intensive treatment.

References (26)

  • M. Oliver

    Serum cholesterol. The knave of hearts and the joker

    Lancet

    (1981)
  • G. Rose et al.

    Plasma lipids and mortality: a source of error

    Lancet

    (1980)
  • Consensus Conference on Lowering Blood Cholesterol to Prevent Heart Disease

    JAMA

    (1985)
  • Committee on Medical Aspects of Food Policy

    Diet and cardiovascular disease

    (1984)
  • Lipid Research Clinics Program The Lipid Research Clinics Coronary Primary Prevention Trial Results: I. Reduction in incidence of coronary heart disease

    JAMA

    (1984)
  • The Lipid Research Clinics Coronary Primary Prevention Trial Results: II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering

    JAMA

    (1984)
  • Relationship of blood pressure, serum cholesterol, smoking habit, relative weight and ECG abnormalities to incidence of major coronary events final report of the Pooling Project

    J Chron Dis

    (1978)
  • Multiple Risk Factor Invertention Trial Research Group

    Coronary heart disease death, non-fatal myocardial infarction and other clinical outcomes in the Multiple Risk Factor Intervention Trial

    Am J Cardiol

    (1986)
  • Dn Wentworth et al.

    An evaluation of the Social Security Administration Master Beneficiary Record file and the National Death Index in the ascertainment of vital status

    Am J Publ Health

    (1983)
  • Wb Kannel, Jd Neaton, D. Wentworth, He Thomas, J. Stamler, Sb Hulley, Mo Kjelsberg, Overall and coronary heart disease...
  • Jd Neaton et al.

    Total and cardiovascular mortality in relation to cigarette smoking, serum cholesterol concentration, and diastolic blood pressure among black and white males followed up for five years

    Am Heart J

    (1984)
  • (1981)
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