Influence of serum triglyceride levels on the risk for myocardial infarction in 12510 middle aged males: interaction with serum cholesterol

Objective: To study the influence of different levels of serum (s)-triglyce rides in relation to s-cholesterol on the risk of myocardial infarction. De sign ann subjects: A 6-13 (mean 10) year follow-up of 12510 middle-aged men . Fasting s-triglycerides and s-cholesterol were measured at the screening examination. Setting: Section of Preventive Medicine at the Department of I nternal Medicine, Malmo General Hospital, an urban hospital for 240000 inha bitants in southern Sweden. Intervention: In minor groups of patients there were interventions addressing high lipid levels, high alcohol consumption, hypertension and glucose intolerance. Main outcome measure: Myocardial inf arction was used as an end-point. Results: 446 myocardial infarctions occur red. The cumulative incidence rates were for the lowest triglyceride quarti le 1.2%, for the second 3.2%, for the third 4.1% and for the highest 5.6%. After adjustment for age, year of screening, body mass index, diabetes, smo king, hypertension and s-cholesterol there was a significant relationship b etween triglycerides and the relative risk for myocardial infarction (P for trend = 0.0087). For increasing levels of triglycerides, adjusted for the above factors except cholesterol, the impact of a certain cholesterol value for the occurrence of myocardial infarction was increased (P for trend = 0 .0092). Conclusions: The present study emphasizes the interaction between c holesterol and triglyceride values for the risk of myocardial infarction. I t is concluded that at triglyceride values above 1.0 mmol/l and cholesterol above 6.8 mmol/l there is an increasing interaction between cholesterol an d triglyceride levels that might be of importance when evaluating the cardi ovascular risk of middle aged men. (C) 1999 Elsevier Science Ireland Ltd. A ll rights reserved.