A. Menotti et al., Long-term time-related predictivity of coronary events as a function of a single measurement of serum cholesterol and systolic blood pressure, ACT CARDIOL, 55(2), 2000, pp. 87-93
Objective - To study the ti me-related association of a single measurement
of serum cholesterol and systolic blood pressure with the occurrence of a f
irst coronary event in a population sample of middle-aged men.
Methods and results - A single measurement of serum total cholesterol and s
ystolic blood pressure (along with age, cigarette consumption, physical act
ivity at work and body mass index as possible confounders) was made in 1,60
5 coronary disease-free men aged 40-59 belonging to the Italian rural cohor
ts of the Seven Countries Study. During 25 years of follow-up 353 men devel
oped a first event, that is a coronary death (sudden or not), and definite
or possible myocardial infarction. Twenty-five partitioned proportional haz
ards models were solved, one for each independent year of follow-up, to pre
dict the risk of incident events. Single-year hazard functions, separately
for serum cholesterol and systolic blood pressure, were cumulated and smoot
hed. The resulting curves showed a regularly increasing risk for coronary e
vents. They fit straight lines, with large correlation coefficients for bot
h serum total cholesterol (r = 0.99) and systolic blood pressure (r = 0.99)
. These slopes were similar to the coefficients estimated by a single propo
rtional hazards model solved for all events during 25 years.
Conclusion - A single measurement of serum total cholesterol and systolic b
lood pressure in middle aged-men maintains a regular and monotonic relation
ship with occurrence of a first coronary event during 25 years of follow-up
.