title: Serum cholesterol is a risk factor for myocardial infarction in elderly men and women: the Rotterdam Study.
abstract: OBJECTIVE
  To investigate the associations of serum total and HDL cholesterol with the risk of myocardial infarction in men and women of 55 years and over.
  
  
  METHODS
  The Rotterdam Study is a population-based prospective cohort study. In total 2453 men and 3553 women of 55 years and older were included in this study. The mean duration of follow-up was 4 years.
  
  
  METHODS
  Relative risks were estimated with Cox's proportional-hazard analysis. Cholesterol was analysed as a continuous variable and in sex-specific quartiles.
  
  
  RESULTS
  In subjects aged 55 years and older the relative risk of myocardial infarction was 1.9 in men (95% confidence interval 1.1-3.3) and 3.2 in women (1.5-6.4) in the highest compared to the lowest serum total cholesterol quartile (Q4 vs. Q1). In men and women of 70 years and older, total cholesterol remained an important risk factor for myocardial infarction (Q4 vs. Q1 relative risk 3.2; 1.3-7.7 and 2.9; 1.3-6.6, respectively). For HDL cholesterol, the relative risk in the highest compared to the lowest quartile (Q4 vs. Q1) was 0.5 in men (0.3-0.9) and 0.4 in women (0.2-0.9). HDL cholesterol was a weaker predictor in men after the age of 70 (Q4 vs. Q1 0.8; 0.3-2.1). In women of 70 years and older the relative risk was also not significant (Q4 vs. Q1 0.6; 0.3-1.3), although the trend over the quartiles was still significant.
  
  
  CONCLUSIONS
  Serum total cholesterol remains an important risk factor for myocardial infarction in men and women aged 70 years and older, whilst HDL cholesterol at older age remains important in women only.
authors.affiliation: Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Houterman
authors.forename: W M
authors.initials: WM
authors.lastname: Verschuren
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: J C
authors.initials: JC
authors.lastname: Witteman
mesh_terms: D000368:Aged; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology*; D009426:Netherlands; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D002784:Cholesterol