Total but not high-density lipoprotein cholesterol is consistently associated with coronary heart disease mortality in elderly men in Finland, Italy,and the Netherlands

We studied the relation between serum total and high-density lipoprotein (H DL) cholesterol and 10-year coronary heart disease mortality in elderly men in different European countries. The Finland, Italy and the Netherlands El derly (FINE) Study is a prospective follow-up study in 2,132 elderly men ag es 65-84 years in Finland, the Netherlands, and Italy. We estimated relativ e risks using Cox proportional hazard analysis with time-dependent covariat es. Total cholesterol was positively related to coronary heart disease mort ality in all three countries. The combined relative risk for the total popu lation of the FINE Study was 1.17 (95% confidence interval = 1.06-1.29) for each 1.00 mmol/liter increase in total cholesterol. HDL chotesterol was in versely related to coronary heart disease mortality in Finland, but not in the Netherlands and Italy. In Italy we noted an interaction among HDL chole sterol, body mass index, and alcohol intake, with an inverse association fo r HDL cholesterol in lean men who drank (<40gm of alcohol daily and a posit ive association for HDL cholesterol among overweight men who drank greater than or equal to 40 gm of alcohol per day. Serum total cholesterol remains an important predictor of coronary heart disease mortality in elderly men i n different European countries. The effect of HDL cholesterol differed amon g the three countries.