Coronary risk factor and lifestyle variation across Scotland: results from the Scottish Heart Health Study

Between 1984 and 1986 the Scottish Heart Health Study recorded coronary risk factors and lifestyle in 10,359 men and women aged 40-59 years across 22 districts of Scotland--districts whose standardised mortality ratio for coronary heart disease in men varied from 61 in Eastwood to 136 in Monklands. This paper presents the results by district. Cigarette smoking levels showed the greatest variation, from 29% to 52% in men and 24% to 51% in women. Blood pressure means varied but were not high (129-138mmHg systolic in men, 126-137mmHg in women, 81-88mmHg diastolic in men and 77-84mmHg in women). Mean serum cholesterol values were high and varied little by district in men, (6.1 to 6.5mmol/l), although there was more variation in women (6.3 to 7.0mmol/l). Body mass index (25.3 to 26.6kg/m2 in men and 24.8 to 26.3kg/m2 in women) also varied little. Distribution of other lipids, fibrinogen, exercise levels and fruit and vegetable consumption is also described. When district mean levels of major coronary risk factors are entered into predictive formulae, cigarette smoking and blood pressure could explain part of the regional variation in mortality, but much remains unaccounted for. Nonetheless, these levels provide data for local preventive initiatives. While the overall pattern and interaction of the factors will repay further study, the high levels of serum cholesterol in all districts, and the level and variation in cigarette smoking, are a challenge for action.     

Variation in coronary risk factor levels of men and women between the German-speaking MONICA centres

The aim of this analysis was to compare levels of risk factors for coronary heart disease (CHD) in men and women aged 25-64 years between German-speaking MONICA collaborating centres, the German Democratic Republic (GDR), Augsburg - the Federal Republic of Germany (FRG)(Au), Bremen - FRG (Br), Heidelberg - FRG (He), and Vaud/Fribourg - Switzerland (CH, with a German-speaking minority). Prevalence of cigarette smoking in men showed little variation in four centres (34 to 40%) and was higher in BR men (49%), while it varied from 17% (GDR) to 33% (BR) in women. Mean total serum cholesterol values (mmol/L) were highest in GDR and CH men (both 6.2) and GDR women (6.1), and lowest in both He men (5.7) and He women (5.6). The proportion with cholesterol values greater than or equal to 6.7 mmol/L was largest in CH men (34%) and smallest in FRG (He) women (17%), while lowering the cut-off point from 6.7 to 6.5 mmol/L raised the prevalence of hypercholesterolaemia in all centres by 5 to 10%. Mean values (mmHg) of blood pressure (BP) were highest in both GDR men (140/88) and women (138/86), as was the prevalence of hypertensive BP values. In all centres, women aged 25-34 had BP values approximately 12/5 mmHg lower than age-matched men, but BP values similar to men at age 55-64, which indicates that age-parallel increase in BP was steeper in women than men.(ABSTRACT TRUNCATED AT 250 WORDS)     

Coronary risk factors in Italian migrants to Australia

Coronary risk factor levels (height, weight, blood pressure, serum total cholesterol, high density lipoprotein (HDL) cholesterol, serum apo-HDL, physical activity, and smoking and drinking habits) were measured in 177 Italian migrants to Australia aged 20-79 years and 176 age-matched native-born Australians of Australian, British or New Zealand parentage. The Italian men had a lower mean systolic and diastolic blood pressure (125.0/79.8 mmHg) than the Australian men (129.4/82.3 mmHg), but Italians of both sexes had higher mean body mass indices (2.8 and 2.9 g/cm2) than Australians (2.4 and 2.5 g/cm2) and Italian women had a significantly lower mean serum HDL cholesterol concentration (1.16 mmol/liter) than Australian women (1.34 mmol/liter). The blood pressure differences between Italians and Australians were increased by adjustment of the means for differences between the two groups in age and obesity. There were slightly more current smokers and drinkers in Italian men than in Australian men; the opposite was true in women. Risk factor levels in Italians were influenced little by duration of residence in Australia. Mortality from ischemic heart disease in Italians in Italy and Italian migrants to Australia is between one third and two thirds that in native-born Australians. The small differences in coronary risk factors observed in this study appear insufficient to explain differences in ischemic heart disease mortality of this size.     

Coffee and tea consumption and the prevalence of coronary heart disease in men and women: results from the Scottish Heart Health Study.

STUDY OBJECTIVES--The aim was to determine if there was a relationship between coffee or tea consumption and the prevalence of coronary heart disease in Scotland. DESIGN--The relationship between self reported coffee and tea consumption and the prevalence of coronary heart disease (history, symptoms, or electrocardiographic evidence) was investigated using multiple logistic regression analysis in the Scottish Heart Health Study (SHHS), a cross sectional study. SETTING--Twenty two Scottish districts were surveyed for the SHHS between 1984 and 1986. SUBJECTS--A total of 10,359 men and women aged 40-59 years were studied. MEASUREMENTS AND MAIN RESULTS--Of the 9740 subjects who were assigned a category, 21.8% (2122) were classified as having indications of coronary heart disease. Men and women were combined in the odds ratio analysis because they showed almost identical patterns in the prevalence of coronary heart disease across the coffee and tea quarters (grouped according to consumption). Those who did not drink coffee had a significantly higher (p < 0.05) prevalence of coronary heart disease than the three groups for coffee drinkers. Adjustments for risk factors including cigarette smoking, total blood cholesterol, and diastolic blood pressure did not remove the significance of the odds ratios. There was a positive dose-response effect between tea consumption and coronary heart disease which was removed after adjustment for various risk factors. CONCLUSIONS--These findings do not support a positive relationship between coffee or tea consumption and coronary heart disease in this British study where most coffee consumed is instant coffee.     

Trend in serum total cholesterol level in 110,000 young adults in The Netherlands, 1974 to 1986.

Data from two screening projects on cardiovascular risk factors were used to analyze the trend in serum total cholesterol level in the Netherlands between 1974 and 1986. Cholesterol levels were measured in a single reference laboratory of the World Health Organization throughout the entire study period. Between 1974 and 1980, about 30,000 men and women aged 37 to 43 years (mean age, approximately 40 years) were screened. A decrease in mean serum total cholesterol level was observed until the end of 1977, when it was followed by an increase. This resulted in a net change over the entire study period of -0.07 mmol/liter (3 mg/dl) in men and -0.03 mmol/liter (1 mg/dl) in women. Between 1981 and 1986, about 80,000 men aged 33 to 37 years (mean age, 35 years) were screened. During this period, a decrease of 0.20 mmol/liter (8 mg/dl) in the mean total cholesterol level was observed. In spite of the decline in the mean total cholesterol level, the prevalence of cholesterol values of greater than or equal to 6.5 mmol/liter (greater than or equal to 251 mg/dl) in young adult men was still high in 1986 (16 percent). A further reduction is therefore desirable. The decline in the mean total cholesterol level in young adults might indicate that a further decline in mortality from coronary heart disease can be expected.     

A comparison of serum total cholesterol levels and their determinants between the Federal Republic of Germany and the United States

Mean serum total cholesterol levels appear to be higher in the Federal Republic of Germany (FRG) than in the United States (US) while coronary heart disease death rates are lower. The study examined possible factors for the difference including possible differences in laboratory methodology. Cross-sectional data from the first two waves of the German National Health Surveys (1984–1986 and 1987–1989; n = 9709) and from the Second National Health and Nutrition Examination Survey (1976–1980; n = 7832) were compared for men and women 25–69 years of age. The influence of age, body mass index, diet, cigarette smoking, education, income, use of oral contraceptives or antihypertensive agents, alcohol consumption and potential differences in laboratory measurement were explored using multiple regression techniques separately for men and women for ages 25–39, 40–59 and 60–69 years of age. Overall ages, unadjusted mean total cholesterol levels were higher in German than US men (6.02 vs. 5.64 mmol/l) and in German than US women (6.04 vs. 5.80 mmol/l) as were HDL cholesterol levels (men: 1.30 vs 1.14 mmol/l; women: 1.65 vs. 1.38 mmol/l). Adjusting for lifestyle factors explained, on the average, 40% of the differences in mean total cholesterol of which half or 20% was accounted for by adjusting for alcohol intake. Adjusting for possible laboratory differences explained, on the average, an additional 30% of the differences. Frequency of alcohol intake was the most important factor in explaining differences in mean HDL cholesterol levels. Adjustment for differences in alcohol intake had negligible effects on reducing the differences in mean non-HDL cholesterol.     

Smoking,blood pressure and serum cholesterol-effects on 20-year mortality

BACKGROUND: To study the impact of smoking and blood pressure conditional on serum total cholesterol levels, we investigated the 20-year mortality risk associated with high systolic blood pressure (> or =140 mmHg) and smoking, at low (<5.2 mmol/Liter), medium (5.2-6.49mmol/Liter), and high (> or =6.5 mmol/Liter) serum total cholesterol levels. METHODS: The study population comprised a cohort of 50,000 men and women age 30-54 years, examined between 1974 and 1980, in five Dutch towns. The duration of follow-up averaged 20 years. Age-adjusted relative risks (RRs) for mortality from coronary heart disease (CHD), cardiovascular diseases (CVD) and all causes were estimated, for six risk profiles (based on levels of total cholesterol, systolic blood pressure and smoking), using Cox proportional hazards analysis. RESULTS: Given a low cholesterol level, smoking had a larger impact than elevated blood pressure on CHD, CVD and all-cause mortality. The combination of elevated blood pressure and smoking among persons with low cholesterol was associated with RRs of 3.0 for CHD, 6.0 for CVD and 4.1 for all-cause mortality in men, and 2.3, 3.6 and 2.6, respectively, in women. Among persons with high cholesterol, the combination of high blood pressure and smoking was associated with RRs of 9.7 for CHD, 13.9 for CVD and 5.7 for all-cause mortality in men, and 15.9, 9.3 and 4.3, respectively, in women. For each risk profile, the absolute number of CHD, CVD and total deaths was larger in men than in women. CONCLUSIONS: The results demonstrate the potential power of a multifactorial approach to risk factor reduction in the prevention of cardiovascular diseases and all-cause mortality.     

Nutrient intakes in North Glasgow: results from the Scottish MONICA studies of 1986 and 1989

As part of the World Health Organisation MONICA project the nutrient intakes of more than 2000 men and women (aged 25–64) were assessed in two cross-sectional surveys carried out in North Glasgow in 1986 and 1989. Mean energy and nutrient intakes were calculated from food frequency questionnaires and results are reported for each survey year for men and women who received only a school education and those who claimed to have completed further education. Mean energy intakes were lower in all groups in 1989 compared with 1986. Men with only a school education had higher mean intakes of energy, starch, total fat, saturated fat, retinol and cholesterol than men who went on to further education. Men and women who had only a school education had lower mean total fibre and vitamin C intakes than those educated beyond school. The percentage contribution of total fat to energy was higher than recent government recommendations in women but was within the guidelines for both groups of men. However alcohol consumption was generally high in both groups of men and this will have contributed to the comparatively low percentage of energy from fat.
Although the quality of the diet was generally better in those who had received further education, the only evidence of an improvement in diet from 1986 to 1989 was in a lower percentage of energy from total fat and saturated fat.     

Plasma lipids and their interrelationship in Turkish adults.

STUDY OBJECTIVE--The aim was to describe the plasma total cholesterol and triglyceride profiles in a random sample of Turkish adults and analyse the effects of certain coronary risk factors on these levels. DESIGN--This was a cross sectional population based survey. SETTING--59 communities scattered in all seven geographical regions of Turkey were surveyed in the summer of 1990. SUBJECTS--A random sample of 3689 men and women 20 years of age and over was studied. MEASUREMENTS AND MAIN RESULTS--Plasma total cholesterol, triglycerides, glucose (using Reflotron and with partial validation in reference laboratory), weight, height, and blood pressure were measured, and information on smoking, physical activity, and family income obtained. Hypercholesterolaemia (> or = 6.5 mmol/litre, 250 mg/dl) prevailed in 8.5%, and hypertriglyceridaemia (> 2.25 mmol/litre, 200 mg/dl) in 16.6% among men and women aged 40-59 years of age. Age adjusted total cholesterol values were 4.8 mmol/litre (185 mg/dl) in men and 5 mmol/litre (192 mg/dl) in women. A steep rise appeared in mean cholesterol levels between the ages of 20-29 and 40-49 years, in a ratio greater than the available data from some other populations indicated. Mean total cholesterol values increased substantially in both genders with diminishing grades of physical activity, rising serum triglyceride levels, in urban (opposed to rural) residents, in men with increasing income levels, and in the younger adults with rising body mass index. CONCLUSIONS--Turkish adults have comparatively low levels of total cholesterol and medium to moderately high levels of triglycerides. Lifestyle factors affect these levels in Turks as in other populations.     

Thirty-year trends in cardiovascular risk factor levels among US adults with diabetes: National Health and Nutrition Examination Surveys, 1971-2000

Among US adults with diabetes, using data from the National Health and Nutrition Examination Survey for 1971-1974, 1976-1980, 1988-1994, and 1999-2000, the authors describe 30-year trends in total cholesterol, blood pressure, and smoking levels. Using Bayesian models, the authors calculated mean changes per year and 95% credible intervals for age-adjusted mean total cholesterol and blood pressure levels and the prevalence of high total cholesterol (> or =5.17 mmol/liter), high blood pressure (systolic blood pressure: > or =140 mmHg and/or diastolic blood pressure: > or =90 mmHg), and smoking. Between 1971-1974 and 1999-2000, mean total cholesterol declined from 5.95 mmol/liter to 5.48 mmol/liter (-0.02 (95% credible interval: -0.03, -0.01) mmol/liter per year). The proportion with high cholesterol decreased from 72% to 55%. Mean blood pressure declined from 146/86 mmHg to 134/72 mmHg (systolic blood pressure: -0.5 (95% credible interval: -1.1, 0.5) mmHg per year; diastolic blood pressure: -0.6 (95% credible interval: -1.0, -0.03) mmHg per year). The proportion with high blood pressure decreased from 64% to 37%, and smoking prevalence decreased from 32% to 17%. Although these trends are encouraging, still one of two people with diabetes has high cholesterol, one of three has high blood pressure, and one of six is a smoker.     

Plasma antioxidants and coronary heart disease: vitamins C and E, and selenium

The possibility of a relation between plasma antioxidants such as vitamins C and E and selenium, and mortality from coronary heart disease (CHD) was examined. A cross-sectional survey was undertaken of random population samples of apparently healthy middle-aged men in four European regions with differing mortalities from CHD [rate/100,000 for men aged 40-49]: north Karelia (eastern Finland) (n = 99) [212/100,000]; south-west Finland (n = 85) [146/100,000]; Scotland (n = 131) [140/100,000]; and south Italy (n = 80) [43/100,000]. Median (5th-95th percentile) plasma vitamin C concentrations were lower in Scotland: 18.2 (5.7-61.3) microM than in other regions: north Karelia 28.4 (6.2-85.2); south-west Finland 33.5 (5.7-76.6); south Italy 38.0 (10.2-69.8) microM (P less than 0.001). The median levels in the four areas did not however reflect the regional CHD mortality rates. Regional differences in plasma vitamin E levels were also observed: Scottish levels were low 20.0 (12.1-29.3) microM (P less than 0.001) and did not differ between the other areas: 23.0 (16.7-35.1), 22.5 (13.7-31.6) and 23.9 (15.6-41.3) microM respectively. The vitamin E gradient could be explained in part by differences in serum cholesterol. However, cholesterol-adjusted vitamin E levels were low in the three high CHD areas: Scotland 3.41 (2.41-4.62); north Karelia 3.53 (2.67-5.18); south-west Finland 3.53 (2.58-4.92); Italy 4.81 (3.25-5.99) mumol/mmol cholesterol (P less than 0.001). Cholesterol-adjusted vitamin E was not lower in north Karelia, the higher CHD mortality area in Finland. Serum selenium values also varied with the area examined and reported low levels in Finland were confirmed. Nevertheless, selenium levels did not correlate with the reported mortality rates of CHD. Thus in our small cross-cultural study the evidence did not support our hypothesis that plasma antioxidants explain regional differences in CHD mortality.     

Low levels of cardiovascular risk factors and coronary heart disease in a UK Chinese population.

OBJECTIVE: To compare the prevalence of cardiovascular risk factors and coronary heart disease in Chinese and Europid adults. DESIGN: Population based, cross sectional survey. SETTING: Newcastle upon Tyne, UK, 1991-93. SUBJECTS: Altogether 380 Chinese and 625 Europid adults, aged 25-64 years. MAIN OUTCOME MEASURES: Fasting lipid levels, blood pressure, body mass index (BMI), the proportions who smoked, and the prevalence of coronary heart disease based on the Rose angina questionnaire and major electrocardiographic abnormalities on resting 12 lead electrocardiogram (Minnesota codes 1.1-1.2). All figures were age adjusted to the 1991 England and Wales population. RESULTS: Altogether 183 and 197 Chinese, and 310 and 315 Europid men and women respectively were seen. Compared with Europid men, Chinese men had a lower mean total cholesterol concentration (5.1 versus 5.6 mmol/l, p < 0.001) and LDL cholesterol (3.2 versus 3.6 mmol/l, p < 0.001); lower BMI values (23.8 versus 26.1 kg/m-2, p < 0.001); and smoked less (23% versus 35%, p < 0.01)). Compared with Europid women, Chinese women also had lower mean lipid levels (total cholesterol: 4.9 versus 5.4 mmol/l p < 0.001, LDL cholesterol: 2.8 versus 3.1 mmol/l p < 0.001); BMI values (23.5 versus 26.1 kg/m-2, p < 0.001); and far fewer were smokers (1.4% versus 33%, p < 0.001). Chinese women, however, had higher mean systolic (121 versus 117 mmHg, p > 0.05) and diastolic (75 versus 68 mmHg, p < 0.001) blood pressures. The prevalence of coronary heart disease was significantly lower in Chinese than Europid men (4.9% versus 16.6%, p < 0.001) but not significantly different in women (7.3% versus 11.1%, p = 0.16). CONCLUSION: Strategies for UK Chinese are needed to maintain this favourable risk factor profile and prevent any potential increase in the risk of coronary heart disease associated with increasing acculturation.     

Serum triglycerides and risk of coronary heart disease among Japanese men and women

To examine the relation of triglycerides with coronary heart disease among populations with low mean total cholesterol, the authors conducted a 15.5-year prospective study ending in 1997 of 11,068 Japanese aged 40-69 years (4,452 men and 6,616 women with mean total cholesterol = 4.73 mmol/liter and 5.03 mmol/liter, respectively), initially free of coronary heart disease or stroke. There were 236 coronary heart disease events comprising 133 myocardial infarctions, 68 angina pectoris events, and 44 sudden cardiac deaths. The coronary heart disease incidence was greater in a dose-response manner across increasing quartiles of nonfasting triglycerides for both sexes. The multivariate relative risk of coronary heart disease adjusting for coronary risk factors and time since last meal associated with a 1-mmol/liter increase in triglycerides was 1.29 (95% confidence interval (CI): 1.09, 1.53; p = 0.004) for men and 1.42 (95% CI: 1.15, 1.75; p = 0.001) for women. The trend was similar for myocardial infarction, angina pectoris, and sudden cardiac death. The relation of triglycerides with coronary heart disease was not influenced materially by total cholesterol levels or, in a subsample analysis (51% of total sample), by high density lipoprotein cholesterol levels. Nonfasting serum triglycerides predict the incidence of coronary heart disease among Japanese men and women who possess low mean values of total cholesterol. Further adjustment for high density lipoprotein cholesterol suggests an independent role of triglycerides on the coronary heart disease risk.     

Cholesterol, coronary heart disease, and total mortality in middle-aged and elderly men and women in Tecumseh.

Relationships between serum cholesterol and coronary heart disease (CHD) were investigated in Tecumseh men and women who were 45 to 92 years old and initially free of CHD. Recruitment continued through three cycles of examinations over a period of 10 years, beginning in 1959. Follow-up for mortality ended in 1986 to 1987. Age-adjusted relative risks for CHD death for cholesterol levels of 5.2 to 6.2 mmol/L and greater than 6.2 mmol/L, compared with levels less than 5.2 mmol/L for men aged 45 to 64 years, were 1.2 and 1.7; for older men they were 1.0 and 1.8. Comparable relative risks for CHD death by cholesterol level were .7 and 1.4 for 45- to 64-year-old women and .8 and .7 for older women. Coefficients for cholesterol were significant for fatal CHD in men under and those 65 years and older when age, systolic blood pressure, body mass index, cigarette smoking status, and glucose intolerance were controlled in proportional hazards models. Cholesterol was a significant predictor of fatal CHD plus nonfatal myocardial infarction in middle-aged, but not elderly women. Relative risks for total mortality were lowest for middle-aged men and women with cholesterol levels of 5.2 to 6.2 mmol/L and the difference was significant in men.     

Serum lipid and apolipoprotein distributions in Hong Kong Chinese.

STUDY OBJECTIVE--The aim was to describe the distribution of lipids and apolipoproteins in the Chinese population in Hong Kong. DESIGN--This was a prospective, cross sectional, population based survey. SETTINGS--The study was conducted in a single, self referred, out patient screening centre. PARTICIPANTS--Altogether 825 Chinese adults aged > or = 20 years were screened. One hundred subjects who had previously had lipid measurement and 29 who were taking lipid modifying drugs were excluded but 289 men and 407 women remained for further analysis. MAIN RESULTS--Age standardised mean (SEM) lipids concentrations for Hong Kong Chinese were total cholesterol: men, 5.48 (0.05) mmol/l and women, 5.46 (0.06) mmol/l; triglycerides: men, 1.22 (1.03) mmol/l and women, 1.00 (1.03) mmol/l; high density lipoprotein (HDL) cholesterol: men, 1.25 (0.02) mmol/l and women, 1.42 (0.02) mmol/l; low density lipoprotein (LDL) cholesterol: men, 3.56 (0.05) mmol/l and women, 3.50 (0.06) mmol/l; apolipoprotein A-I (apo A-I): men, 1.34 (0.01) g/l and women, 1.46 (0.01) g/l; and apolipoprotein B (apo B): men, 1.15 (0.02) g/l and women, 1.06 (0.02) g/l. The total to HDL cholesterol ratios were men, 4.62 (0.07) and women, 4.10 (0.08); and apo B to apo A-I ratios (apo B/A) were men, 0.88 (0.02) and women, 0.75 (0.02). While levels of total cholesterol, LDL cholesterol, apo B, triglycerides, total/HDL cholesterol, and apo B/A were positively associated with age in both sexes and were higher in men before the age 50-59 years, they rose steeply thereafter in women to cross over the levels in men. In contrast, HDL cholesterol decreased with age while apo A-I remained constant, and both were consistently higher in women than in men in all age groups. CONCLUSIONS--Hong Kong Chinese have attained lipid profiles similar to those in other developed western populations. Environmental factors seem influential in this regard. Faced with the increasing coronary mortality of recent years, there should be a major effort to reduce the cholesterol concentrations in this population.     

Risk factors for coronary heart disease and level of education. The Troms? Heart Study

The relation between level of education, lifestyle variables, and major risk factors for coronary heart disease were analyzed in 12,368 men and women in Troms?, Norway. Subjects with the highest education tended to be less overweight, smoke less, be more physically active in leisure time, and have food habits assumed to be less atherogenic (i.e., drink less coffee, use soft margarine and low-fat milk, and eat fruits and vegetables daily) than persons with low education. In men and women, mean serum total cholesterol and systolic blood pressure were negatively associated with educational level, while high density lipoprotein (HDL) cholesterol was positively associated with this variable in women only. The differences between the extreme groups of education (less than 8 and greater than 16 years of education) were as follows: 0.52 mmol/liter (20 mg/100 ml) for serum total cholesterol; 0.03 and 0.14 mmol/liter (1 and 5 mg/100 ml) in men and women, respectively, for HDL cholesterol; and 1.9 and 5.6 mmHg in men and women, respectively, for systolic blood pressure. Adjustment of the relations between level of education and serum total cholesterol and systolic blood pressure for several variables (including food habits) reduced the strength of the associations, which, however, were still statistically significant. For HDL cholesterol, a negative association was found in men when adjustments were done, and the positive association originally observed in women disappeared.     

上海市松江区泗泾地区健康人群血脂水平调查与分析

目的调查泗泾地区人群血脂水平和血脂谱现状,探讨泗泾镇高脂血症发病情况及高脂血症与年龄、血致动脉硬化指数（AIP）水平关系,为血脂异常防治提供客观依据。方法收集2010年4—12月在泗泾医院体检的8098例人员资料,并测定甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL—C）,计算出非高密度脂蚕白胆固醇（non—HDL—C）、AIP,并按不同年龄段进行分组,将各组进行比较分析。结果TC水平最高男性为4．83mmol/L,女性为5．24mmol／L,高水平年龄在61—70岁;TG水平最高男性为2．02mmol/L,女性为1．67mmol／L,年龄在41-70岁：HDL-C最低水平为1．12mmol／L,各年龄段均在合适水平;LDL—C最高男性为2．36mmol／L,女性为2．47mmol／L,年龄在31～70岁．健康人异常脂蛋白血症发生率（按2007年《中国成人血脂异常防治指南》中血脂水平划分方案划1分为TC38．89％、TG32．21％、HDL—C24．92％和LDL—C5．09％。结论该地区健康人TC、TC、HDL—C和LDL—C整体水平明显高于2002年中国营养与健康调查血脂在人群中的水平。血脂谱以异常高TC占首位,依次为TG、HDL—C和LDL—C．高TG血症发生率（32．21％）与高TC血症发生率（38．49％）相差不多,应重视高TG血症防治。     

An eight-month controlled study of a low-fat high-fibre diet: effects on blood lipids and blood pressure in healthy young subjects.

The effects on blood lipids and blood pressure of a diet corresponding to present Nordic Nutrition Recommendations, i.e. less than 30% of energy from fat and with a fibre content exceeding 3 g/MJ, were studied in 18 men and 12 women (mean age, 24 years) under strict dietary control over 8 months. Blood sampling, blood pressure and body weight measurement were performed at four occasions on their habitual diet and once a month during the intervention period. An age-matched control group (17 men, 8 women) was followed with monthly measurements parallel to the intervention group. The habitual diets, assessed by 7-day records, showed an average fat content corresponding to 36% of energy. Initial levels of total cholesterol and HDL cholesterol (X +/- SD) were 4.21 +/- 0.61 and 1.23 +/- 0.23 mmol/l for the men in the intervention group; 4.35 +/- 0.79 and 1.21 +/- 0.26 mmol/l for the male controls; 4.61 +/- 0.59 and 1.46 +/- 0.31 mmol/l for the women in the intervention group and 4.48 +/- 0.64 and 1.48 +/- 0.29 mmol/l for the female controls. Significantly decreased levels of total cholesterol and HDL cholesterol throughout the experimental period were seen for both sexes in the intervention group. Total cholesterol fell 0.49 mmol/l (95% CI: 0.41-0.56) in the male subjects and 0.49 mmol/l (95% CI: 0.39-0.59) in the female subjects. The fall in HDL cholesterol was 0.16 mmol/l (95% C: 0.13-0.18) and 0.18 mmol/l (95% CI: 0.12-0.23), respectively. Total cholesterol changes were independent of initial values. All subjects were normotensive at the start of the study with an average blood pressure of 122/68 mmHg for men and 112/68 mmHg for the women. Systolic blood pressure dropped gradually and significantly in the male subjects of the intervention group. A minimum of 6 mmHg below initial values was noted after six months of dietary intervention. No significant changes in dietary intake and blood lipids were observed in the control group. Thus, changes of present dietary habits of young healthy Danish subjects to an intake in accordance with the Nordic Nutrition Recommendations 1989 will favourably affect suggested risk factors for disease.     

Birth weight, childhood growth, and cardiovascular disease risk factors in Japanese aged 20 years

To determine whether birth weight and childhood growth, especially rate of height increase, are independently related to major cardiovascular disease risk factors in adult life, the authors conducted a 20-year follow-up study in a Japanese population, using the record-linkage method. From medical checkup data for babies and for residents aged 20 years in Ishikawa, Japan, the authors obtained 20-year follow-up data (1985-1994) on 4,626 participants (2,198 men and 2,428 women) born in 1965-1974. Using multiple linear regression analysis, the authors estimated that a 1-standard-deviation higher birth weight was significantly associated with systolic blood pressure that was lower by 1.6 mmHg in men and by 1.0 mmHg in women, and with a serum cholesterol level that was lower by 0.07 mmol/liter in men and by 0.04 mmol/liter in women, after adjustment for current weight and rate of height increase. Moreover, after adjustment for birth weight and current weight, a 1-standard-deviation higher rate of height increase from age 3 years to age 20 years was significantly associated with systolic blood pressure that was lower by 0.7 mmHg in men and by 0.5 mmHg in women, and with serum cholesterol that was lower by 0.09 mmol/liter in men and by 0.05 mmol/liter in women. The results suggest that lower birth weight and lower rate of height increase during childhood are independently associated with increases in blood pressure and serum cholesterol in adult life.     

The challenge of secondary prevention for coronary heart disease in older patients: findings from the British Women's Heart and Health Study and the British Regional Heart Study

BACKGROUND: Secondary prevention of coronary heart disease (CHD) among older individuals is associated with considerable benefit. METHODS: In this study, we have examined the extent of secondary prevention among British women and men aged 60-79 years who were surveyed and examined between 1998 and 2001. RESULTS: Among 483 women (12.1% of the whole sample) and 831 men (19.5%) with CHD, >90% of both sexes had at least one modifiable risk factor, with over two-fifths having high blood pressure and over three-quarters high cholesterol. For total cholesterol and body mass index, mean values in both male and female subjects were above recommended levels, and a large shift in the population distributions would be required for targets to be met. Less than one-quarter of subjects of either sex were on a statin, and whilst the majority of men were taking an antiplatelet medication, only 40% of women were. CONCLUSIONS: Most older women and men in Britain were failing to meet National Service Framework standards for secondary prevention in the period immediately before its implementation. Large shifts in the population distributions of some risk factors would be required in this group to meet these standards.