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Cholesterol and Coronary Heart Disease Mortality

Cholesterol and Coronary Heart Disease Mortality A 23-year follow-up study of 10 059 40- to 65-year-old participants In the Israeli Ischemlc Heart Disease Study found that of 3473 deaths (34.5&percnt;), In 1098 (10.9&percnt;) coronary heart disease (CHD) was the underlying cause. Total serum cholesterol (TC) was measured in 9902 Individuals. During the study, CHD mortality was elevated primarily In Individuals in qulntiles 4 and 5 (TC levels 2217 mg/dl). Although CHD mortality Increased marginally with Increasing TC at levels below 217 mg/dl, this was entirely explained by age and other correlated risk factors In a multlvarlate adjustment of the survival curves. The “net” 23-year survival in terms of CHD was 87&percnt; in qulntlle 5 (TC>241) versus 93&percnt; In qulntile 1 (TC<176 mg/dl). CHD mortality was Inversely related to the percent of cholesterol In high density llpoproteln (PHDL). All-cause mortality Increased only when TC was above 240 mg/dl and In the subjects with PHDL levels in the lowest 20&percnt;. Lfpids appeared to be somewhat less effective In predicting subsequent CHD mortality than did hypertension and smoking and were clearly secondary In assessing risk of all-cause death. The results raise the question whether Intensive treatment for hypercholesterolemla is Indicated for men at “borderline” levels. We conclude that the association between serum cholesterol and long-term mortality partly reflects the role that levels of co-existing CHD risk factors play In prognosis. At the “borderline-high” cholesterol range, where preventive studies of clinically manifested end points have not been conducted and survival Is only marginally Jeopardized, the Identification and management of nonllpld CHD factors may constitute a primary preventive approach among men In populations with temporal patterns and risk factor-mortality associations similar to the ones In our cohort. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Arteriosclerosis Wolters Kluwer Health

Cholesterol and Coronary Heart Disease Mortality

Arteriosclerosis , Volume 10 (4) – Jul 1, 1990

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Copyright
© 1990 by American Heart Association, Inc.
ISSN
0276-5047

Abstract

A 23-year follow-up study of 10 059 40- to 65-year-old participants In the Israeli Ischemlc Heart Disease Study found that of 3473 deaths (34.5&percnt;), In 1098 (10.9&percnt;) coronary heart disease (CHD) was the underlying cause. Total serum cholesterol (TC) was measured in 9902 Individuals. During the study, CHD mortality was elevated primarily In Individuals in qulntiles 4 and 5 (TC levels 2217 mg/dl). Although CHD mortality Increased marginally with Increasing TC at levels below 217 mg/dl, this was entirely explained by age and other correlated risk factors In a multlvarlate adjustment of the survival curves. The “net” 23-year survival in terms of CHD was 87&percnt; in qulntlle 5 (TC>241) versus 93&percnt; In qulntile 1 (TC<176 mg/dl). CHD mortality was Inversely related to the percent of cholesterol In high density llpoproteln (PHDL). All-cause mortality Increased only when TC was above 240 mg/dl and In the subjects with PHDL levels in the lowest 20&percnt;. Lfpids appeared to be somewhat less effective In predicting subsequent CHD mortality than did hypertension and smoking and were clearly secondary In assessing risk of all-cause death. The results raise the question whether Intensive treatment for hypercholesterolemla is Indicated for men at “borderline” levels. We conclude that the association between serum cholesterol and long-term mortality partly reflects the role that levels of co-existing CHD risk factors play In prognosis. At the “borderline-high” cholesterol range, where preventive studies of clinically manifested end points have not been conducted and survival Is only marginally Jeopardized, the Identification and management of nonllpld CHD factors may constitute a primary preventive approach among men In populations with temporal patterns and risk factor-mortality associations similar to the ones In our cohort.

Journal

ArteriosclerosisWolters Kluwer Health

Published: Jul 1, 1990

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