Serum Total Cholesterol and Mortality

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Abstract
Objective. —To further investigate the relationship between serum total cholesterol (TC) level and mortality due to major causes. In particular, is the elevated mortality among persons with low TC levels due to confounding conditions that both lower TC level and increase the risk of mortality, and is the association between low or high TC level and mortality homogeneous in the population or, alternatively, restricted to persons with other risk factors? Study Design. —Prospective cohort study. Setting. —Free-living population in Oahu, Hawaii. Participants. —A total of 7049 middle-aged men of Japanese ancestry. Main Outcome Measures. —Age- and risk factor—adjusted mortality due to coronary heart disease, hemorrhagic stroke, cancer, chronic obstructive pulmonary disease, nonmalignant liver disease, trauma, miscellaneous and unknown, and all causes. Results. —During 23 years of follow-up, a total of 1954 deaths were documented (38% cancer, 25% cardiovascular, and 37% other). Men with low serum TC levels (JAMA. 1995;273:1926-1932)