Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity
Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity
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DOI：
10.1001/jama.284.3.311
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发表时间：
2000-07-19
影响因子：
120.7
通讯作者：
Neaton, JD
中科院分区：
文献类型：
--
作者：
Stamler, J;Daviglus, ML;Neaton, JD
背景根据中年队列(年龄40-)的观察和干预数据，已知血清胆固醇水平是冠心病(CHD)的主要危险因素。然而，针对年轻人的研究结果是有限的，检测和治疗年轻人高胆固醇血症的价值还存在争议。目的评估不良血清胆固醇水平对冠心病、心血管疾病(CVD)和所有原因死亡风险的长期影响，设计、设置和参与者三项前瞻性研究，从中选择了3组基线血清胆固醇水平测量且无糖尿病或心肌梗死病史的年轻男性。1967-1973年芝加哥心脏协会工业检测项目(CHA)共筛查了11017名年龄在18岁至39岁的男性；1959年至1963年在People Cas Company Study(PCI)中筛查了1266名年龄在25岁至39岁之间的男性；1973-1975年间筛查了69 205名年龄在35岁至39岁之间的男性(MRFIT)。主要结果衡量了25年(CHA)、34年(PCI)和16年(MRFIT)随访期间的死因特定死亡率；死亡风险；结果CHA、PC和MRFIT队列中死于CHD的人数分别占全部死亡人数的26%、34%和28%；心血管疾病死亡人数分别占同一队列中死亡人数的34%、42%和39%。在血清胆固醇水平(2 0 0~2 39 mg/dL[5.17~6.18 mm ol/L]和大于或等于2 40 mg/dl[大于或等于6.2 1 mm o l/L]的3个队列中，男性的相对死亡风险有很强的梯度。对于血清胆固醇水平在240mgdL或以上(大于或等于6.21mmoL/L)的男性，
Context Based on observational and interventional data for middle-aged cohorts (aged 40-64 years), serum cholesterol level is known to be an established major risk factor for coronary heart disease (CHD). However, findings for younger people are limited, and the value of detecting and treating hypercholesterolemia in younger adults is debated.Objective To evaluate the long-term impact of unfavorable serum cholesterol levels on risk of death from CHD, cardiovascular disease (CVD), and all causes,Design, Setting, and Participants Three prospective studies, from which were selected 3 cohorts of younger men with baseline serum cholesterol level measurements and no history of diabetes mellitus or myocardial infarction. A total of 11 017 men aged 18 through 39 years screened in 1967-1973 for the Chicago Heart Association Detection Project in Industry (CHA); 1266 men aged 25 through 39 years examined in 1959-1963 in the Peoples Cas Company Study (PCI); and 69 205 men aged 35 through 39 years screened in 1973-1975 for the Multiple Risk Factor Intervention Trial (MRFIT).Main Outcome Measures Cause-specific mortality during 25 (CHA), 34 (PCI), and 16 (MRFIT) years of follow-up; mortality risks; and estimated life expectancy in relation to baseline serum cholesterol levels.Results Death due to CHD accounted for 26%, 34%, and 28% of all deaths in the CHA, PC, and MRFIT cohorts, respectively; and CVD death for 34%, 42%, and 39% of deaths in the same cohorts, respectively. Men in all 3 cohorts with unfavorable serum cholesterol levels (200-239 mg/dL [5.17-6.18 mmol/L] and greater than or equal to 240 mg/dl [greater than or equal to 6.21 mmol/L]) had strong gradients of relative mortality risk. For men with serum cholesterol levels of 240 mg/dL or greater (greater than or equal to 6.21 mmol/L) vs favorable levels (