Analysis of the data derived in the course of examination of men aged 20 to 69 years demonstrates a distinct rise of the prevalence of CHD and AH with age. The level of the total cholesterol also increases with advancing age, reaching a maximum at 40 to 49 years as does the level of Tg (maximal at 50 to 59 years). The body weight also shows a linear increase. Emphasis should be placed on a high alpha-cholesterol content in persons aged 30 to 39 years. Analysis of the nutrition pattern of the male population aged 20 to 69 years revealed an atherogenic nature of nutrition marked by a high quota of fat, saturated fatty acids, low ratio of polyunsaturated to saturated fatty acids, and high cholesterol consumption with food. The highest consumption of energy sources and animal products was noted in persons aged 30 to 39 years. The same age demonstrated the lowest consumption of products of vegetable origin. Persons aged 50 to 59 years showed a reduction in consumption of protein of animal origin and essential polyunsaturated fatty acids as well as an increase in consumption of readily available sugars, which may lead to the development of obesity and hypertriglyceridemia and therefore to a higher risk of CHD development.
The objective of the present study was to examine the possible associations between low molecular weight (LMW) apolipoprotein(a) (apo(a)) isoforms (F,B,S1,S2) and coronary heart disease (CHD). We conducted a nested case-control (prospective) study of five cohorts of white men: The 1936 cohort (baseline 1976, n = 548) and four cohorts from MONICA I born in 1923 (n = 463), 1933 (n = 491), 1943 (n = 504) and 1953 (n = 448) studied at baseline in 1983. At follow up in 1991, 52 subjects had developed a first myocardial infarction and 22 had been hospitalized with angina pectoris. Plasma samples obtained at baseline were stored frozen until 1993-94, when case samples (n = 74) were analyzed together with samples from matched (disease free) controls (n = 190). In a statistical model (conditional logistic regression) including all age groups, cholesterol (or apo B) level (P
A case-control study was conducted to investigate the association between serum selenium and risk of death from acute coronary heart disease (CHD) as well as risk of fetal and non-fetal myocardial infarction (MI). Case-control pairs came from a population of 11,000 persons examined in 1972 from two counties in eastern Finland, an area with an exceptionally high mortality from cardiovascular diseases. Cases were aged 35-59 years and had died of CHD or other CVD or had a non-fetal MI during a seven-year follow-up. Controls were matched for sex, age, daily tobacco consumption, serum cholesterol, diastolic blood pressure, and history of angina pectoris. The mean serum selenium concentration for all cases was 51.8 micrograms/l and for all controls 55.3 micrograms/l (p less than 0.01). Serum selenium of less than 45 micrograms/l was associated with an adjusted relative risk of CHD death of 2.9 (p less than 0.01, 95% CI, 1.4-6.0), a relative risk of CVD death of 2.2 (p less than 0.01, 95% CI, 1.2-4.0), and a relative risk of fatal and nonfatal MI of 2.1 (p less than 0.001, 95% Ci, 1.4-3.1). 22% (95% CI, 8-35%) of contrary deaths were attributable to serum selenium in the whole study population.
Whether glucose and insulin are differently associated with the risk of coronary heart disease (CHD) mortality is unclear. We aimed to estimate the association between insulin resistance (estimated by the homeostasis model assessment for insulin resistance, HOMA-IR), fasting serum insulin (FI) and fasting plasma glucose (FPG) with incident CHD mortality in a prospective study including middle-aged nondiabetic Finnish men. During an average follow-up of 20 years, 273 (11 %) CHD deaths occurred. In a multivariable Cox regression analysis adjusted for age, body mass index, systolic blood pressure, serum LDL-cholesterol, cigarette smoking, history of CHD, alcohol consumption, blood leukocytes and plasma fibrinogen, the hazard ratios (HRs) for CHD mortality comparing top versus bottom quartiles were as follows: 1.69 (95 % CI: 1.15-2.48; p = 0.008) for HOMA-IR; 1.59 (1.09-2.32; p = 0.016) for FI; and 1.26 (0.90-1.76; p = 0.173) for FPG. These findings suggest that IR and FI, but not FPG, are independent risk factors for CHD mortality. Further studies could help clarify these results in terms of screening and risk stratification, causality of the associations, and therapeutical implications.
Recent data suggest that infections, inflammation and the immune system are involved in the process of atherosclerosis. The aim of the present study was to analyze the association of coronary heart disease (CHD) with three inflammation markers, C-reactive protein (CRP), serum amyloid-A (SAA) and plasma fibrinogen. The cross-sectional study included 1400 men aged 45-74 years, who participated in a cardiovascular risk factor survey in Finland in 1997. Participants with prevalent CHD had markedly higher CRP, SAA and fibrinogen levels than participants without CHD. In logistic regression models, the age, smoking, serum cholesterol and systolic blood pressure adjusted odds ratios (2nd, 3rd and 4th quartile as compared with the 1st quartile) of CHD increased gradually with increasing quartile of CRP (1.90, 2.27, 2.64), SAA (1.68, 1.83, 2.41), and fibrinogen (1.60, 1.95, 2.14). The associations weakened somewhat after further adjustment for indicators of obesity, particularly waist hip-ratio. CRP, SAA and fibrinogen levels were markedly lower among CHD patients using cholesterol-lowering medication as compared to non-users. In conclusion, CRP, SAA and fibrinogen, which are markers of inflammation, were positively and significantly associated with prevalent CHD. Central obesity needs to be considered as a confounding factor in the observed associations. These findings support the hypothesis that cholesterol-lowering drugs have an anti-inflammatory effect.
BACKGROUND: Short body height is associated with increased risk for coronary heart disease; however, mechanisms are not fully explained. In this study, associations between body height and serum cholesterol, non-high-density lipoprotein (non-HDL cholesterol) and high-density lipoprotein (HDL cholesterol) were investigated. METHODS: Prospective cohort study of middle-aged men from Helsingborg, Sweden starting 1990. Two birth-year cohorts were invited at 37, 40 and 43 years of age; participation at baseline was 991 (68%). Serum and HDL cholesterol, systolic and diastolic blood pressure, weight, height, waist and hip circumferences were measured. Non-HDL cholesterol, body mass index (BMI) and waist/ hip ratio (WHR) were calculated. The participants completed a questionnaire covering lifestyle variables. RESULTS: There were statistically significant inverse correlations between body height and serum cholesterol (-0.11) and non-HDL cholesterol (-0.12). One standard deviation, 6.7 cm, taller body height was associated with a lower serum cholesterol (-0.12 mmol/l) and a lower non-HDL cholesterol (-0.13 m mol/l; p
The prevalence of atherosclerotic vascular disease (ASVD) and its risk factors were investigated in 263 insulin-treated diabetic patients, ages 45 to 64 years, who were older than 30 years when their diabetes was diagnosed. The patients were divided into two groups based on the degree of endogenous insulin secretion capacity: Group A: glucagon-stimulated plasma C-peptide less than 0.20 nmol/l and Group B: C-peptide greater than or equal to 0.20 nmol/l. The age-adjusted prevalence of definite myocardial infarction was significantly higher in Group B than in Group A (16.8% vs. 5.2%, p less than 0.01). A similar difference between Groups A and B was found for definite or possible coronary heart disease (54.6% vs. 32.9%, p less than 0.001) and stroke (9.3% vs. 2.0%, p less than 0.05). In multivariate analysis, high glucagon-stimulated plasma C-peptide level (greater than or equal to 0.20 nmol/l) was positively associated with definite or possible coronary heart disease independently of other cardiovascular risk factors. Our results indicate that among insulin-treated patients with a late onset of diabetes, the prevalence of ASVD is markedly higher in those with persistent endogenous insulin secretion (noninsulin-dependent diabetes) than in those with low or no insulin secretion (insulin-dependent diabetes).
The association between behavioral and somatic coronary risk indicators was studied in 3-, and 6-, and 9-year-old children (n = 668). The behavioral risk indicators used were the Type A behavior pattern, hyperactivity, social maladjustment, and life dissatisfactions of the mother. The somatic risk indicators adopted were serum concentrations of apolipoproteins B and A-I. The results might indicate that behavioral and somatic coronary risk indicators are not independent, but could share a common basis, or pathways that are related to the pathogenesis of CHD. In addition, a sex-related difference was discovered: variables associated with the high somatic risk level among girls were hyperactivity, social maladjustment, and impatience, and among boys the variables were the mother's dissatisfaction with herself as a mother, leadership, and a tendency for competitiveness-aggression.
A large multicentre study of coronary heart disease risk factors and their determinants in children and adolescents was planned in the late 1970s. The main cross-sectional study with 3,596 subjects was made in 1980, and two follow-up studies have been carried out, in 1983 and 1986, respectively. In addition, a study with 630 newborns was carried out in 1981, and a series of children aged 1 to 36 months was collected in 1981-1982. Cord blood, serum cholesterol was about 1.5 mmol/l, which is no different from the level found in other studies. The diet of mothers had no effect on the cholesterol values of the newborns. The cholesterol level of infants and small children was correlated with the amount and quality of fat eaten. The dietary habits of the family were correlated with the family's standard of education, which calls for intervention measures already in early childhood. Serum cholesterol levels have decreased in Finnish children during the 1980s by about 1% per year, which should be reflected in coronary heart disease morbidity and mortality in the future.