Abstract
Absolute risk of coronary heart disease was investigated through a cohort study in a district of Niigata Prefecture, Japan. Among 7, 263 participants, 17 acute myocardial infarction, 13 coronary deaths and 14 cases of angina pectoris were observed during 5 years from the baseline survey. Multivariate analysis by the Cox proportional hazard model revealed that serum total cholesterol over 250 mg/dl was a risk factor for acute myocardial infarction. The role of high serum cholesterol in risk, however, was evident only for subjects with one or more other risk factors, such as diabetes, obesity, high systolic blood pressure, low serum HDL-cholesterol and low frequency of vegetable intake, simultaneously. Absolute risk of coronary heart disease, including acute myocardial infarction, coronary death and angina pectoris, over 5 years exceeded 10% only for males 65 years of age or older, if they also had high serum total cholesterol and one of the other risk factors simultaneously. The absolute risk for males younger than 65 years and for females did not reach 10% regardless of their risk factor status. Thus, drug therapy for high serum total cholesterol should be considered only for very limited group of subjects, if the European guidelines are applied. We should take these results into consideration in daily health guidance for subjects with high serum total cholesterol aimed for primary prevention of coronary heart disease.
