Smoking, blood pressure and serum cholesterol as risk factors of acute myocardial infaction and death among men in Eastern Finland

The impact of smoking, serum cholesterol and blood pressureon the risk of acute myocardial infarction and death due toall causes and cardiovascular diseases was studied in a randomsample of men aged 35 to 59 years from the North Karelia andKuopio counties of Eastern Finland. This is an area with anexceptionally high incidence of coronary heart disease. Altogether,4034 men were studied with a participation rate of 92%. Thesemen were followed-up with a myocardial infarction register anddeath certificate data. During the first five years 256 deathsoccurred among all subjects. There were 66 acute myocardialinfarctions in the North Karelian men reporting no recent coronaryheart disease. Smoking, elevated serum cholesterol and bloodpressure were independently and jointly related to an increasedrisk of acute myocardial infarction and death due to all causesand to cardiovascular disease. Smokers had a 2–3-foldage-adjusted risk of acute myocardial infarction, a 2-2-foldrisk of any death and a 2.1-fold risk of cardiovascular deathcompared with non-smokers. The age-adjusted risk ratios forsystolic blood pressure of 160 mm Hg or more were 1.3, 1.4 and1.9 and those for serum cholesterol at least 8 mmol/l (309 mg/100ml) 2.6, 1.5 and 2.6 concerning myocardial infarction, all deathsand cardiovascular deaths, respectively. All risk ratios exceptthat of systolic blood pressure for acute myocardial infarctionwere significant at levels of at least P < 0.05