Copyright © 2002 by the European Society of Cardiology.
Combined effects of systolic blood pressure and serum cholesterol on cardiovascular mortality in young (<55 years) men and women
Center "Investigations Preventives et Cliniques" (IPC), Paris, France
revised July 17, 2001; accepted July 18, 2001
Abstract
Aims To evaluate the combined effects of the two most frequent modifiable risk factors, systolic blood pressure and serum cholesterol, on cardiovascular and coronary mortality, in a large French population aged 18 to 55 years.
Methods and Results We studied 108879 men (mean age 39·1±9·4 years) and 84931 women (mean age 37·3±10·0 years) who had a health check-up at the IPC Center between 1978 and 1988. Mortality data for a mean period of 13 years were analysed. Systolic blood pressure and cholesterol levels were classified according to the cut-points proposed by international guidelines. In men, the prevalence of high cholesterol was more than twice as high in hypertensives as in normotensives; in women, it was more than three times higher. The combination of these two risk factors has additive effects on cardiovascular disease and coronary heart disease risk. In men, a borderline elevation of both systolic blood pressure (130–139mmHg) and cholesterol (200–239mg.dl–1) leads to a three- to four-fold increase in cardiovascular disease risk. Men with systolic blood pressure 
160mmHg represent a small percentage (about 5%) who have a 10-fold increase in cardiovascular disease and coronary heart disease risk, especially when high cholesterol is present. In women of the same age, similar trends were observed, but the results were less significant, probably due to the low cardiovascular disease mortality rates.
Conclusions In conclusion, in French subjects under 55 years of age, a combination of high systolic blood pressure and high serum cholesterol dramatically increased cardiovascular disease and coronary heart disease risk, especially in men. A more aggressive public health policy is needed to prevent the development of risk factors in younger subjects.
Key Words: Cholesterol, systolic blood pressure, cardiovascular disease, coronary heart disease, age, gender
f1 Correspondence: Athanase Benetos, MD, PhD, IPC Center, 6/14 rue la Pérouse, 75116 Paris, France.
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