Short and long term association of a single serum cholesterol measurement in middle-aged men in prediciton of fatal coronary and other cardiovascular events: a cross-cultural comparison through Europe

Aims: The purpose was to study the association of a single serum cholesterol measurement with early and late coronary and other cardiovascular deaths during 35 years of follow-up in samples of men aged 40¿59 years in five European countries. Methods and results: A single serum total cholesterol measurement was considered in samples from Finland (N = 1563), the Netherlands (N = 811), Italy (N = 1642), Serbia (N = 1537) and Greece (N = 1158) (total = 6711). Seven partitioned proportional hazards models were solved, one for each of seven independent 5-year blocks, to predict coronary, stroke, cardiovascular disease and all-cause mortality risk. Partitioned hazard scores were cumulated. The resulting curves showed a relatively constant strength in risk for coronary deaths as a function of baseline serum cholesterol levels, although a strong relationship during the first 10-year period was followed by a weaker relationship later on. The pooled estimates for the five countries gave a relative risk for 1 mmol/l of serum cholesterol (95% confidence intervals) of 1.44 (1.23¿1.68) for the first period; 1.52 (1.31¿1.76) for the second period; and 1.16 (1.02¿1.32) for the third period; 1.18 (1.05¿1.32) for the forth period; 1.17 (1.05¿1.31) for the fifth period; 1.22 (1.10¿1.35) for the sixth period; 1.18 (1.05¿1.32) for the seventh 5-year period of follow-up. No significant relationship were found between serum cholesterol and stroke and all-cause mortality, while intermediate findings were obtained for cardiovascular diseases. Conclusion: A single serum cholesterol measurement in middle aged-men maintains a strong relationship with the occurrence of coronary heart disease (CHD) deaths during 35 years of follow-up.