CHANGES IN POPULATION CHOLESTEROL LEVELS AND CORONARY HEART-DISEASE DEATHS IN 7 COUNTRIES

Background Are trends in coronary heart disease deaths based on risk f actor changes? Objective To study the: relationship between trends in coronary deaths and changes in blood cholesterol in the Seven Countrie s Study. Material and Methods Sixteen cohorts of men aged 40-59 years from seven countries (U.S.A., Finland, the Netherlands, Italy, Croatia (former Yugoslavia), Serbia (former Yugoslavia), Greece, Japan) were units for the analyses of serum cholesterol measured at entry and afte r 5 and IO years. and for mortality over 25 years. Results In the popu lations, the ecological relationship of mean serum cholesterol at entr y to late corollary heart disease death rates during the 10- to 25-yea r follow-up was weak, with an R-square of 0.31. Cholesterol measuremen ts made at year 10, and an indicator of cholesterol change during the first II) years, increased the association (R-square, 0.49), A negativ e and significant interaction was shown between baseline population ch olesterol levels and their 10-year change. As an indicator of accelera tion in mortality, cholesterol change over 10 years was also positivel y correlated (partial R-square 0.44) with the ratio of 25-year to 5-ye ar deaths, Conclusions In the Seven Countries Study, late coronary hea rt disease death rates are largely 'explained' by changes in blood cho lesterol levels during the early phases of the study, mainly due to in creases in lower cholesterol levels among some cohorts.