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The effect of coronary heart disease prevention on the prevention of non-cardiovascular diseases

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Atherosclerosis and Cardiovascular Disease

Abstract

At the preceding Bologna meeting, evidence was presented that measures to prevent coronary heart disease (CHD) are likely to provide protection against some of the other, major chronic diseases as well [1]. Of the latter, the most important is cancer in its different manifestations. During the last few years, a high level of consensus has been reached that CHD is, indeed, preventable through risk factor control and that both a population and a high-risk strategy are needed to make prevention optimally effective on the population level [2–6]. However, there is still opposition to these recommendations, even though they become more and more accepted by the scientific and medical community.The most serious of these objections is the allegation that the reduction in CHD risk resulting from lowering one of the three main risk factors, serum cholesterol, would be counterbalanced by an increase in cancer risk, leaving total mortality unchanged [7]. It is the present purpose to show that these concerns are unfounded, based on a comprehensive review of available data, bearing both on cancer and total mortality.

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References

  1. Epstein,F.H. (1986) ‘Prevention of coronary heart disease-links with other chronic disorders’, in S. Lenzi and G.C. Descovich eds., Atherosclerosis and Cardiovascular Diseases, MTP Press Ltd. Lancaster, Boston, The Hague, Dordrecht, pp. 157–162.

    Google Scholar 

  2. Prevention of coronary heart disease’ (1982) Report of a W.H.O. Expert Committee, Technical Report Series 678, World Health Organization, Geneva, Switzerland.

    Google Scholar 

  3. Study Group, European Atherosclerosis Society (1987) ‘Strategies for the prevention of coronary heart disease’, Europ.Heart J. 8, 77–88.

    Google Scholar 

  4. Study Group, European Atherosclerosis Society (1988) ‘The recognition and management of hyperlipidaemia in adults: a policy statement of the European Atherosclerosis Society’, Europ.Heart J. 9, 571–600.

    Google Scholar 

  5. The Expert Panel (1988) ‘Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults’, Arch.Int.Med. 148, 36–69.

    Article  Google Scholar 

  6. Havel,R.J. (1988) ‘Lowering cholesterol, 1988, rationale, mechanisms and means’, J.Qin.Invest. 81, 1653–1660.

    Article  CAS  Google Scholar 

  7. Oliver,M.F. (1988) ‘Reducing cholesterol does not reduce mortality’, J.Am.Coll.Cardiol. 12, 814–817.

    Article  CAS  PubMed  Google Scholar 

  8. Ederer,F. et al. (1971) ‘Cancer among men on cholesterol-lowering diets. Experience from clinical trials’, Lancet 2, 203–206.

    Article  CAS  PubMed  Google Scholar 

  9. Anon (1981) ‘Cholesterol and non-cardiovascular mortality’, J.Am.Med.Ass. 246, 731.

    Article  Google Scholar 

  10. Workshop on cholesterol, and non-cardiovascular disease mortality’, National Heart, Lung and Blood Institute and National Cancer Institute, National Institutes of Health, Bethesda, Maryland, U.S.A., May 11–12, 1981.

    Google Scholar 

  11. Cambien,F., Ducimetière,P. and Richard,J. (1980) ‘Total serum cholesterol and cancer mortality in a middle-aged male population’, Am. J.Epidemiol. 112, 388–394.

    CAS  PubMed  Google Scholar 

  12. Rose,G. and Shipley,M.J. (1980) ‘Plasma lipids and mortality: a source of error’, Lancet 1, 523–525.

    Article  CAS  PubMed  Google Scholar 

  13. Wallace,R.B. et al. (1982) ‘Cancer incidence in humans: relationships to plasma lipids and relative weight’, J.Nat.Cancer Inst. 68, 915–918.

    CAS  PubMed  Google Scholar 

  14. International Collaborative Group (1982) ‘Circulating cholesterol level and risk of death from cancer in men aged 40 to 69 years’, J.Am.Med. Ass. 248, 2853–2859.

    Article  Google Scholar 

  15. Hiatt,R.A. and Firemen,B.H. (1986) ‘Serum cholesterol and the incidence of cancer in a large cohort’, J.Chronic Dis. 39, 861–870.

    Article  CAS  PubMed  Google Scholar 

  16. Sherwin,R.W. et al. (1987) ‘Serum cholesterol levels and cancer mortality in 361 662 men screened for the multiple risk factor intervention trial’, J.Am.Med.Ass. 257, 943–948.

    Article  CAS  Google Scholar 

  17. Knekt,P. et al. (1988) ‘Serum cholesterol and risk of cancer in a cohort of 39,000 men and women’, J.Clin.Epidemiol. 41, 519–530.

    Article  CAS  PubMed  Google Scholar 

  18. KarkJ.D., Smith,A.H. and Hames,C.G. (1980) ‘The relationship of serum cholesterol to the incidence of cancer in Evans County, Georgia’, J.Chronic Dis. 33, 311–322.

    Article  CAS  PubMed  Google Scholar 

  19. Beaglehole,R. et al. (1980) ‘Cholesterol and mortality in New Zealand Maoris’, Brit.Med.J. 1, 285–287.

    Article  Google Scholar 

  20. Garcia-Palmieri,M.R. (1981) ‘An apparent inverse relationship between serum cholesterol an cancer mortality in Puerto Rico’, Am.J.Epidemiol. 114, 29–40.

    CAS  PubMed  Google Scholar 

  21. Kagan,A. et al (1981) ‘Serum cholesterol and mortality in a Japanese-American population’, Am. J.Epidemiol. 114, 11–20.

    CAS  PubMed  Google Scholar 

  22. Williams,R.R. et al. (1981) ‘Cancer incidence by level of cholesterol’ (Framingham Study), J.Am.Med.Ass. 245,247–252.

    Article  CAS  Google Scholar 

  23. BottigerJL.E. and Carlson,L.A. (1982) ‘Risk factors for death for males and females’, Acta Med.Scand. 211, 437–442.

    Article  PubMed  Google Scholar 

  24. Petersen,B., Trell,E. and Sternby,N.H. (1981) ‘Low cholesterol level as risk factor for noncoronary death in middle-aged men’, J.Am.Med.Ass. 245, 2056–2057.

    Article  Google Scholar 

  25. Gerhardsson,M. et al. (1986) ‘Serum cholesterol and cancer - a retrospective case-control study’, Int.J.Epidemiol. 15, 155–159.

    Article  CAS  PubMed  Google Scholar 

  26. Schatzkin,A. et al. (1988) ‘Site-specific analysis of total serum cholesterol and incident cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study’, Cancer Research 48, 452–458.

    CAS  PubMed  Google Scholar 

  27. Isles,C.G. et al. (1989) ‘Plasma cholesterol, coronary heart disease, and cancer in the Renfrew and Paisley survey’, Brit.Med.J. 298, 920–924.

    Article  CAS  PubMed  Google Scholar 

  28. Kozarevic,D. et al. (1981) ‘Serum cholesterol and mortality. The Yugoslavia Cardiovascular Disease Study’, Am. J.Epidemiol. 114, 21–28.

    CAS  PubMed  Google Scholar 

  29. Keys,A. et al. (1985) ‘Serum cholesterol and cancer mortality in the Seven Countries Study’, Am.J.Epidemiol. 121, 870–883.

    CAS  PubMed  Google Scholar 

  30. ,K. and Nicolaysen,R. (1972) ‘Ten-year mortality and morbidity related to serum cholesterol’, Scand.J.Clin.Labor.Invest. 30, Suppl. 127, 3–24.

    Google Scholar 

  31. SalonenJ. (1982) ‘Risk of cancer and death in relation to serum cholesterol’, Am.J.Epidemiol. 116, 622–630.

    CAS  PubMed  Google Scholar 

  32. Dyer,A.R. et al. (1981) ‘Serum cholesterol and risk of death from cancer and other causes in three Chicago epidemiological studies’, J.Chronic Dis. 34, 249–620.

    Article  CAS  PubMed  Google Scholar 

  33. Thomas,C.B., Duszynski,K.R. and Schaffer,J.W. (1982) ‘Cholesterol levels in young adulthood and subsequent cancer: a preliminary note’, Johns Hopkins Med.J. 150, 89–94.

    CAS  PubMed  Google Scholar 

  34. Wingard,D.L. et al. (1984) ‘Plasma cholesterol and cancer morbidity and mortality in an adult community’, J.Chronic Dis. 37, 401–406.

    Article  CAS  PubMed  Google Scholar 

  35. Yaari,S. et al. (1981) ‘Associations of high density lipoprotein and total cholesterol with total cardiovascular, and cancer mortality in a 7-year prospective study of 10,000 men’, Lancet 1, 1013–1015.

    Google Scholar 

  36. Morris,D.L. et al. (1983) ‘Serum cholesterol an cancer in the Hypertension Detection and Follow-up Program’, Cancer 52, 1754–1759.

    Article  CAS  PubMed  Google Scholar 

  37. Törnberg,S.A. et al. (1986) ‘Risk of cancer of the colon and rectum in relation to serum cholesterol and betalipoprotein’, New Eng.J.Med. 315, 1629–1633.

    Article  PubMed  Google Scholar 

  38. Mannes,G.A. et al. (1986) ‘Relation between the frequency of colorectal adenoma and the serum cholesterol level’, New Eng.J.Med. 315, 1634–1638.

    Article  CAS  PubMed  Google Scholar 

  39. Rose,G. et al. (1974) ‘Colon cancer and blood-cholesterol’, Lancet 1, 181–183.

    Article  CAS  PubMed  Google Scholar 

  40. Stemmermann,G.N. et al. (1981) ‘Serum cholesterol and colon cancer incidence in Hawaian Japanese men’, J.Nat.Cancer Inst. 67, 1179–1182.

    CAS  PubMed  Google Scholar 

  41. Sorlie,P.D. and Feinleib,M. (1982) ‘The serum cholesterol-cancer relationship: an analysis of time trends in the Framingham Study’, J.Nat.Cancer Inst. 69, 989–996.

    CAS  PubMed  Google Scholar 

  42. Davis,C.E. et al (1983) ‘Serum cholesterol and cancer mortality: Evans County 20-year follow-up study’, in: E.G.Perkins, W.J.Visek, eds., Dietary Fats and Health, Am. Oil Chemists Soc., Champaign, Illinois, pp. 892–900.

    Google Scholar 

  43. Sydney,S. and Farquhar,J.W. (1983) ‘Cholesterol, cancer, and public health policy’, Am.J.Med. 75, 494–508.

    Article  Google Scholar 

  44. Keys,A. (1980) Seven Countries - A Multivariate Analysis of Death and Coronary Heart Disease, Harvard University Press, Cambridge, Mass. and London.

    Google Scholar 

  45. Yusuf,S. and Furberg,C.D. (1987) ‘Single factor trials’, in: A.G.Olsson,ed.,Atherosclerosis - Biology and Clinical Science, Churchill Livingstone, Edinburgh, London, Melbourne and New York, pp. 389–398.

    Google Scholar 

  46. Yusuf,S., Wittes,J. and Friedman,L. (1989) ‘Randomized clinical trials in heart disease’, J.Am.Med.Ass., 261, 2953–2954 (letter to the Editor).

    Google Scholar 

  47. Yusuf,S., Wittes,J. and Friedman,L. (1988) ‘Overview of results of randomized clinical trials in heart disease, II’ J.Am.Med.Ass. 260, 2259–2263.

    Article  CAS  Google Scholar 

  48. Dayton,S. et al. (1969) ‘A controlled trial of a diet high in unsaturated fat’, Circulation 40 (Suppl.II) 1–62.

    Google Scholar 

  49. Frantz,I.D., Jr. et al. (1989) ‘Test of effect of lipid lowering by diet on cardiovascular risk’, Arteriosclerosis 9, 129–135.

    Article  PubMed  Google Scholar 

  50. Hjerman,I. et al. (1981) ‘Effect of diet and smoking intervention on the incidence of coronary heart disease’, Lancet 2, 1303–1310.

    Article  Google Scholar 

  51. Committee of Principal Investigators (1980) ‘WHO Cooperative Trial on primary prevention of ischaemic heart disease using clofrbrate to lower serum cholesterol: mortality follow-up’, Lancet 2, 379–385.

    Google Scholar 

  52. Lipid Research Clinics Program (1984) ‘The Lipid Research Clinics Coronary Primary Prevention Trial results’, J.Am.Med.Ass. 251, 351–364.

    Article  Google Scholar 

  53. Frick,M.H. (1987) ‘Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia’, New Eng.J.Med. 317,1237–1245.

    Article  CAS  PubMed  Google Scholar 

  54. Multiple Risk Factor Intervention Trial Research Group (1982) ‘Multiple risk factor intervention trial. Risk factor changes and mortality results’, J.Am.Med.Ass. 284, 1465–1477.

    Google Scholar 

  55. WHO European Collaborative Group (1986) ‘European Collaborative Trial of multifactorial prevention of coronary heart disease: final report on the 6-year results’, Lancet 1, 869–872.

    Google Scholar 

  56. Wilhelmsen,L. et al. (1986) ‘The multifactor primary prevention trial in Göteborg, Sweden’, Europ.Heart J. 7, 279–288.

    CAS  Google Scholar 

  57. Miettinen,T.A. et al. (1985) ‘Multifactorial primary prevention of cardiovascular diseases in middle-aged men’, J.Am.Med.Ass. 254, 2097–2102.

    Article  CAS  Google Scholar 

  58. Rose,G. (1987) ‘European Collaborative Trial of multifactorial prevention of coronary heart disease’, Lancet 1, 685 (letter to the Editor).

    Google Scholar 

  59. Anon (1989) ‘Low cholesterol and increased risk’, Lancet 1, 1423–1425.

    Google Scholar 

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© 1990 Kluwer Academic Publishers

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Epstein, F.H. (1990). The effect of coronary heart disease prevention on the prevention of non-cardiovascular diseases. In: Descovich, G., Gaddi, A., Magri, G., Lenzi, S. (eds) Atherosclerosis and Cardiovascular Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0731-7_2

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  • DOI: https://doi.org/10.1007/978-94-009-0731-7_2

  • Publisher Name: Springer, Dordrecht

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