TOTAL AND CORONARY HEART-DISEASE MORTALITY IN RELATION TO MAJOR RISK-FACTORS - QUEBEC CARDIOVASCULAR STUDY

  • 1 March 1990
    • journal article
    • research article
    • Vol. 6  (2) , 59-65
Abstract
The relationships of blood pressure, smoking, serum cholesterol and education levels on total and coronary artery disease (CAD) mortality were evaluated in 4576 Quebec men aged 35 to 64 years, free from overt CAD at entry and followed for 12 years. From January 1974 to January 1986, there were 417 deaths, 131 due to CAD. A progressive increase in total and CAD mortality was observed from quintile 3 to 5 for both systolic and diastolic blood pressure. In comparison to quintile 1, the adjusted relative risks of quintiles 4 and 5 for systolic blood pressure were significantly elevated (2P<0.01), being 1.5 and 2.0 for total mortality, and 2.6 and 3.5 for CAD mortality, respectively. The relative risks of quintiles 4 and 5 for diastolic blood pressure were also significantly elevated (2P<0.04), being 1.5 and 1.6 for total mortality and 1.9 and 2.7 for CAD mortality, respectively. In comparison to those who never smoked, the relative risks of smoking one to 20, and 21 and more cigarettes per day, were 2.1 (2P<0.003) and 3.1 (2P<0.0001) for overall mortality, and 2.2 (2P<0.08) and 3.5 (2P<0.002) for CAD mortality. Men who had discontinued smoking at least one year before the study, had a relative risk not different from those who had never smoked. Serum cholesterol and education levels were not significantly associated with total or CAD mortality. Although the lack of relationship of cholesterol to CAD mortality may be attributed to several factors, a low prevalence of elevated cholesterol and a limited number of CAD deaths are considered as possible explanations. Thus, for these Quebec men, smoking is an important risk factor for both total and CAD mortality, while systolic and diastolic blood pressure elevation had a greater impact upon CAD than total mortality. A longer follow-up is necessary to evaluate the role of cholesterol on CAD mortality in this population.

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