Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study

摘要: Objective. —To compare the relationship between serum total cholesterol and long-term mortality from coronary heart disease (CHD) in different cultures. Design. —Total was measured at baseline (1958 through 1964) 5- 10-year follow-up 12 467 men aged 40 59 years 16 cohorts located seven countries: five European countries, United States, Japan. To increase statistical power six were formed, based on similarities culture changes during first 10 of follow-up. Main Outcome Measures. —Relative risks (RRs), estimated with Cox proportional hazards (survival) analysis, for 25-year CHD quartiles per 0.50-mmol/L (20-mg/dL) increase. Adjustment made age, smoking, systolic blood pressure. Results. —The age-standardized rates ranged 3% to 20%. The RRs highest compared lowest quartile 1.5 2.3, except Japan's RR 1.1. For a level around 5.45 mmol/L (210 mg/dL), varied 4% 5% Japan Mediterranean Southern Europe about 15% Northern Europe. However, relative due given similar all cultures Using linear approximation, corresponded an risk 12%, which became 17% when adjusted regression dilution bias. Conclusion. —Across cultures, is linearly related mortality, same. large difference absolute level, however, indicates that other factors, such as diet, are typical low also important respect primary prevention. (JAMA. 1995;274:131-136)