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Short and long term association of a single serum cholesterol measurement in middle-aged men in prediction of fatal coronary and other cardiovascular events: A cross-cultural comparison through Europe

  • Cardiovascular Diseases
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Abstract

Aims: The purpose was to study the association of a single serum cholesterol measurement with early and late coronary and other cardiovascular deaths during 35 years of follow-up in samples of men aged 40–59 years in five European countries. Methods and results: A single serum total cholesterol measurement was considered in samples from Finland (N = 1563), the Netherlands (N = 811), Italy (N = 1642), Serbia (N = 1537) and Greece (N = 1158) (total = 6711). Seven partitioned proportional hazards models were solved, one for each of seven independent 5-year blocks, to predict coronary, stroke, cardiovascular disease and all-cause mortality risk. Partitioned hazard scores were cumulated. The resulting curves showed a relatively constant strength in risk for coronary deaths as a function of baseline serum cholesterol levels, although a strong relationship during the first 10-year period was followed by a weaker relationship later on. The pooled estimates for the five countries gave a relative risk for 1 mmol/l of serum cholesterol (95% confidence intervals) of 1.44 (1.23–1.68) for the first period; 1.52 (1.31–1.76) for the second period; and 1.16 (1.02–1.32) for the third period; 1.18 (1.05–1.32) for the forth period; 1.17 (1.05–1.31) for the fifth period; 1.22 (1.10–1.35) for the sixth period; 1.18 (1.05–1.32) for the seventh 5-year period of follow-up. No significant relationship were found between serum cholesterol and stroke and all-cause mortality, while intermediate findings were obtained for cardiovascular diseases. Conclusion: A single serum cholesterol measurement in middle aged-men maintains a strong relationship with the occurrence of coronary heart disease (CHD) deaths during 35 years of follow-up.

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References

  1. A Menotti S Giampaoli (1998) ArticleTitleA single risk factor measurement predicts 35-year mortality from cardiovascular disease G Ital Cardiol 28 1354–1362 Occurrence Handle9887388

    PubMed  Google Scholar 

  2. A Menotti M Lanti PE Puddu (2000) ArticleTitleLong term time- related predictivity of coronary events as a function of a single measurement of serum cholesterol and systolic blood pressure Acta Cardiol 55 87–94 Occurrence Handle10779852

    PubMed  Google Scholar 

  3. A Menotti M Lanti (2001) ArticleTitleThe duration of the association between serum cholesterol and coronary mortality: a 35-year experience J Cardiov Risk 8 109–117 Occurrence Handle10.1097/00043798-200104000-00008

    Article  Google Scholar 

  4. A Menotti M Lanti (2003) ArticleTitleCoronary risk factors predicting early and late coronary deaths Heart 89 19–24 Occurrence Handle10.1136/heart.89.1.19 Occurrence Handle12482784

    Article  PubMed  Google Scholar 

  5. Keys A, Blackburn H, Menotti A, et al. (ed) Coronary heart disease in seven countries. Circulation 1970, 41, (suppl 1): 1–211

    Google Scholar 

  6. GA Rose H Blackburn (1968) Cardiovascular Survey Methods World Health Organization Geneva

    Google Scholar 

  7. JT Anderson A Keys (1956) ArticleTitleCholesterol in serum and lipoprotein fractions: its measurement and stability Clin Chem 2 145–159 Occurrence Handle13317101

    PubMed  Google Scholar 

  8. InstitutionalAuthorNameWorld Health Organization (1965) International classification of diseases and causes of death 8th World Health Organization Revision Geneva

    Google Scholar 

  9. DR Cox (1972) ArticleTitleRegression models and life tables J Roy Stat Soc 74 187–220

    Google Scholar 

  10. InstitutionalAuthorNameBMDP (1992) Dynamic Statistical Software Release 7.0 BMDP Inc., Cork Technology Park Ireland

    Google Scholar 

  11. AR Dyer (1986) ArticleTitleA method for combining results from several prospective epidemiological studies Stat Med 5 303–317 Occurrence Handle3764222

    PubMed  Google Scholar 

  12. OO Aalen (1989) ArticleTitleA linear regression model for the analysis of life times Stat Med. 8 907–925 Occurrence Handle2678347

    PubMed  Google Scholar 

  13. S MacMahon R Peto J Cutler et al. (1990) ArticleTitleBlood pressure, stroke, and coronary heart disease. Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias Lancet 335 765–774 Occurrence Handle10.1016/0140-6736(90)90878-9 Occurrence Handle1969518

    Article  PubMed  Google Scholar 

  14. R Clarke S Lewington L Youngman et al. (2002) ArticleTitleUnderestimation of the importance of blood pressure and cholesterol for coronary heart disease mortality in old age Eur Heart J 23 286–293 Occurrence Handle10.1053/euhj.2001.2781 Occurrence Handle11812064

    Article  PubMed  Google Scholar 

  15. A Menotti F Seccareccia M Lanti et al. (1993) ArticleTitleTime changes in predictability of coronary heart disease in an Italian aging population Cardiology 82 172–180 Occurrence Handle8324778

    PubMed  Google Scholar 

  16. RJ Benfante DM Reed CJ MacLean et al. (1989) ArticleTitleRisk factors in middle age that predict early and later onset of coronary heart disease J Clin Epidemiol 42 95–104 Occurrence Handle10.1016/0895-4356(89)90082-6 Occurrence Handle2918328

    Article  PubMed  Google Scholar 

  17. J Pekkanen A Nissinen S Punsar et al. (1992) ArticleTitleShort- and long-term association of serum cholesterol with mortality. The 25-year follow-up of the Finnish cohorts of the Seven Countries Study Am J Epidemiol 135 1251–1258 Occurrence Handle1626541

    PubMed  Google Scholar 

  18. J Pekkanen M Tervahauta A Nissinen et al. (1993) ArticleTitleDoes the predictive value of baseline coronary risk factors change over a 30-year follow-up? Cardiology 82 181–190 Occurrence Handle8324779

    PubMed  Google Scholar 

  19. MJ Shipley SJ Pocock MG Marmot (1991) ArticleTitleDoes plasma cholesterol concentration predict mortality from coronary heart disease in elderly people? 18 year follow-up in Whiteall study Br Med J. 303 89–92

    Google Scholar 

  20. Greenland P, Daviglus ML, Liu K, et al. Do major CHD risk factors have power to predict more distant CHD and all causes mortality? The Chicago Heart Association Detection Project in Industry. Proc. 38th Annual Conference on Cardiovascular Disease Epidemiology and Prevention. Santa Fe, New Mexico, USA: American Heart Association, March 1998, 18–21

  21. TA Manolio TA Pearson NK Wenger et al. (1992) ArticleTitleCholesterol and heart disease in older persons and women. Review of an NHLBI workshop Ann Epidemiol 2 161–176 Occurrence Handle1342259

    PubMed  Google Scholar 

  22. A Menotti DR Jacobs H Blackburn et al. (1996) ArticleTitleTwenty-five-year prediction of stroke deaths in the seven countries study The role of blood pressure and its changes. Stroke 27 381–387

    Google Scholar 

  23. Prospective Studies Collaboration. Cholesterol, diastolic blood pressure and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Lancet 1995, 346: 1647–1653

    Google Scholar 

  24. A Menotti H Blackburn D Kromhout et al. (2001) ArticleTitleCardiovascular risk factors as determinants of 25-year all-cause mortality in the seven countries study Eur J Epidemiol 17 337–346 Occurrence Handle11767959

    PubMed  Google Scholar 

  25. WB Kannel JD Neaton D Wentworth et al. (1986) ArticleTitleOverall and coronary heart disease mortality rates in relation to major risk factors in 325,348 men screened for the MRFIT Am Heart J 112 825–836 Occurrence Handle3532744

    PubMed  Google Scholar 

  26. J Stamler AR Dyer RB Shekelle J Neaton R Stamler (1993) ArticleTitleRelationship of baseline major risk factors to coronary and all-cause mortality and to longevity: findings from long-term follow-up of Chicago cohorts Cardiology 82 191–222 Occurrence Handle8324780

    PubMed  Google Scholar 

  27. M Kornitzer M Dramaix I Beriot M Lannoy H Gheyssens F Kittel (1993) ArticleTitleTwenty-five-year mortality follow-up in the Belgian Bank Study Cardiology 82 153–171 Occurrence Handle8324777

    PubMed  Google Scholar 

  28. RJ Goldberg M Larson D Levy (1996) ArticleTitleFactors associated with survival to 75 years of age in middle-aged men and women Arch Intern Med 156 505–509 Occurrence Handle8604956

    PubMed  Google Scholar 

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Menotti, A., Lanti, M., Kromhout, D. et al. Short and long term association of a single serum cholesterol measurement in middle-aged men in prediction of fatal coronary and other cardiovascular events: A cross-cultural comparison through Europe. Eur J Epidemiol 20, 597–604 (2005). https://doi.org/10.1007/s10654-005-7918-8

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  • DOI: https://doi.org/10.1007/s10654-005-7918-8

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