Serum Cholesterol, Blood Pressure, Cigarette Smoking, and Death From Coronary Heart Disease Overall Findings and Differences by Age for 316099 White Men

TLDR

The study assessed how blood pressure, serum cholesterol, and cigarette smoking jointly influence coronary heart disease mortality and how these associations differ by age in 316,099 men. Data on these risk factors and mortality were collected from men screened for the Multiple Risk Factor Intervention Trial (MRFIT). Over an average 12‑year follow‑up, 6,327 CHD deaths were recorded, revealing strong graded links between cholesterol >4.65 mmol/L, systolic BP >110 mm Hg, diastolic BP >70 mm Hg and mortality; smokers with high cholesterol and BP had about 20‑fold higher CHD death rates than nonsmokers with low levels, and all three factors were significant predictors across age groups, with systolic BP being the strongest predictor, supporting intensified prevention for all ages. Arch Intern Med 1992;152:56‑64.

Abstract

To assess the combined influence of blood pressure (BP), serum cholesterol level, and cigarette smoking on death from coronary heart disease (CHD) and to describe how these associations vary with age, data on those factors and on mortality for 316 099 men screened for the Multiple Risk Factor Intervention Trial (MRFIT) were examined. Vital sta tus of participants has been determined after an average follow-up of 12 years; 6327 deaths from CHD have been identified. Strong graded relationships between serum cho lesterol levels above 4.65 mmol/L (180 mg/dL), systolic BP above 110 mm Hg, and diastolic BP above 70 mm Hg and mortality due to CHD were evident. Smokers with serum cholesterol and systolic BP levels in the highest quintiles had CHD death rates that were approximately 20 times greater than nonsmoking men with systolic BP and cholesterol lev els in the lowest quintile. Systolic and diastolic BP, serum cholesterol level, and cigarettes per day were significant predictors of death due to CHD in all age groups. Systolic BP was a stronger predictor than diastolic BP. These results, together with the findings of clinical trials, offer strong support for intensified preventive efforts in all age groups. (<i>Arch Intern Med</i>. 1992;152:56-64)