Total cholesterol concentration and mortality at a relatively young age: do men and women differ?
OBJECTIVE
To investigate the relation between total cholesterol concentration and mortality from coronary heart disease, cardiovascular diseases, non-cardiovascular causes, and all causes.


METHODS
Population based cohort study.


METHODS
23,000 men and 26,000 women aged 30-54 years examined between 1974 and 1980.


METHODS
Mortality for the above mentioned end points for fifths of cholesterol distribution, and relative risks estimated by using Cox's proportional hazard (survival) analysis. Adjustment was made for age, smoking, systolic blood pressure, and body mass index.


RESULTS
Mortality from coronary heart disease in men was five times higher than that in women. A strong positive association between total cholesterol concentration and mortality from coronary heart disease and cardiovascular diseases was observed in both men and women. The relative risk for the highest compared with the lowest fifth of the cholesterol distribution was for mortality from coronary heart disease (3.0 (95% confidence interval 1.8 to 5.1) in men and 3.8 (1.1 to 13.1) in women) and for mortality from cardiovascular disease (2.8 (1.8 to 4.2) in men and 2.9 (1.4 to 6.0) in women). No increase of non-cardiovascular mortality at low cholesterol concentration was observed. All cause mortality was significantly higher in the highest compared with the lowest fifth of the cholesterol distribution: relative risk 1.6 (1.3 to 2.0) in men and 1.5 (1.1 to 1.9) in women.


CONCLUSIONS
Total cholesterol concentration is a strong predictor of mortality from coronary heart disease, cardiovascular diseases, and all causes in women as well as in men. Low cholesterol concentrations are not associated with increased mortality from non-cardiovascular causes.
Monique Verschuren
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WM
Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Netherlands.
Kromhout
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D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands; D011159:Population Surveillance; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis
D002784:Cholesterol