New results confirm NCEP guidelines
New results confirm NCEP guidelines
A study published in the July 19, 2000, Journal of the American Medical Association confirms that what’s been known about cholesterol in men ages 40 to 64 also is true for men ages 18 to 39: Hypercholesterolemia is a risk factor for coronary heart disease (CHD) in both age groups.1
Jeremiah Stamler and colleagues evaluated data and the relationships between serum cholesterol and long-term mortality from CHD, cardiovascular disease (CVD), and all causes based on three cohorts of younger men from the Chicago Heart Association Detection Project in Industry (CHA), Chicago Peoples Gas company (PG), and Multiple Risk Factor Intervention Trial (MRFIT) studies.
A total of 81,488 men were followed for as many as 34 years. Relative risk (RR) of CHD death in the CHA, PG, and MRFIT cohorts were 1.80, 1.42, and 1.49, respectively, for cholesterol levels higher than 40 mg/dL. Those RR figures were higher than for cohorts of middle-aged men (ages 40 to 59, 40 to 49, and 40 to 57 in the studies), in whom RR was 1.2, 1.10, and 1.29 for CHA, PG, and MRFIT, respectively.1
Further evidence from this study shows that "there is a continuous, graded, strong, independent relationship of serum cholesterol level to long-term risk of CHD and CVD death, stronger than for men with like serum cholesterol levels measured in middle age."1 The study confirms the importance of prevention of hypercholesterolemia starting early in life, as well as proper lifestyle and eating habits. Early detection and treatment also is confirmed in the paper.
Scott M. Grundy, in an accompanying editorial, points out that "even moderate reductions of cholesterol levels by diet will substantially reduce long-term risk for CHD."2 He writes that patients should concentrate on changes in lifestyle, including smoking cessation, weight control, exercise, and avoidance of foods containing saturated fats and high cholesterol.
Grundy concludes his editorial by saying that "detection of high serum cholesterol levels is a necessary first step in the effort to reduce risk of CHD in the one-third of young adults who have total cholesterol levels higher than 200 mg/dL. The current evidence supports recommendations for measurement of cholesterol levels in adults aged 20 years or older at least once every 5 years."2
References
1. Stamler J, Daviglus ML, Garside DB, et al. 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. JAMA 2000; 284:311-318.
2. Grundy SM. Early detection of high cholesterol levels in young adults. JAMA 2000; 284:365-367.
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