THE MUNSTER HEART-STUDY (PROCAM) - RESULTS OF FOLLOW-UP AT 8 YEARS

The Munster Heart Study (PROCAM) was initiated in 1979 in order to exa mine cardiovascular risk factors. cardiovascular events including myoc ardial infarction and stroke, and mortality in people at work. Examina tion at entry comprised a standardized case history, measurement of bl ood pressure and anthropometric data, a resting electrocardiogram, and measurement of more than 20 laboratory parameters in a fasting blood sample. The prevalence data in this report are based upon a single exa mination of 17437 men aged 40.4 +/- 11.3 years (mean +/- SD) and 8065 women aged 35.7 +/- 12.1 years, which took place between 1979 and 1991 . Severe hypercholesterolaemia (>300 mg.dl(-1)) was seen in 5% of men and 8% of women aged 45 to 64 years. In men. the prevalence of hypertr iglyceridaemia (>200 mg.dl(-1)) rose from 5% at age 20 to 20% at age 4 5 and remained constant thereafter: in women the prevalence of hypertr iglyceridaemia increased linearly from 2% at age 20 to 7% at age 60. T he LDL/HDL ratio was higher in men than in women at all age groups. in the age group 45 to 64 years, LDL/HDL ratios >5 were approximately tw ice as common in men. Lipoprotein(a) levels were distributed in a high ly skewed fashion. In men, a slight rise in the geometric mean lipopro tein(a) concentration occurred with age, whereas in women a dramatic i ncrease was seen after age 40. Using multivariate analysis by the mult iple logistic function method, total cholesterol, HDL cholesterol, LDL cholesterol and log-transformed triglycerides showed a significant (P <0.001) age-adjusted correlation with the presence of major coronary e vents. A risk algorithm has been developed for men aged 40 to 65 years which takes into account the independent risk factors of HDL choleste rol, LDL cholesterol. triglycerides, fibrinogen, age, systolic blood p ressure, cigarette smoking, presence of diabetes mellitus and family h istory of myocardial infarction and angina pectoris. This algorithm ca n br used in clinical practice to calculate the 8-year risk of an indi vidual suffering a myocardial infarction.