Association of lipids and lipoprotein level with total mortality and mortality caused by cardiovascular and cancer diseases (Poland and United StatesCollaborative Study on Cardiovascular Epidemiology)

This study evaluates the relation between total serum cholesterol, triglyce rides, and high-density lipoprotein (HDL) cholesterol, and subsequent total , cardiovascular, and cancer mortality. These data are from 4,946 US and 5, 198 Polish men and women aged 35 to 64 years at baseline with mortality fol low-up over 13 years. Total cholesterol showed a U-shaped or J-shaped relat ion to age-adjusted total and cancer mortality across all samples, with sig nificance only in Polish women. The multivariable adjusted relative risk fo r total and cancer mortality was higher in the lowest cholesterol category only in Poland and significant only for cancer. Cardiovascular mortality wa s positively related to cholesterol, but only in Polish men and US women wa s mortality significantly higher in the highest versus the lowest cholester ol category. The multivariable adjusted relative risk of cardiovascular dea th wets greater in the highest versus the lowest cholesterol category, but this trend was significant only in the US. HDL cholesterol was inversely re lated to total (significant only in US men) and cardiovascular mortality (s ignificant only in US and Polish men). A similar, but not significant, asso ciation of HDL cholesterol was found with cancer mortality. The multivariab le adjusted relative risk of total mortality was inversely related to HDL c holesterol significant in both the US and Poland. The relative risk of card iovascular mortality was significantly lower at higher HDL cholesterol leve ls in all samples. The relative risk of cancer mortality was highest and si gnificant at the lowest HDL cholesterol level in the US and Poland. Elevate d triglycerides were associated with increased risk of total and cardiovasc ular mortality, but this trend was significant only in the US. Cancer morta lity was not significantly related to triglycerides. The present study indi cates that in geographically and culturally diverse populations, the relati on of lipids with cardiovascular mortality is similar. The relation with to tal and cancer mortality varies by country, gender, and lipids. This sugges ts that relations of total and cancer mortality with lipids or lipoproteins are weaker than associations with cardiovascular mortality. (C) 1999 by Ex cerpta Medica, Inc.