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.
References
- Kannel WB. Risk stratification in hypertension: new insights from the Framingham Study. Am J Hypertension. 2000;13:3S–10S[Web of Science][Medline]
- Bonaa KH, Thelle DS. Association between blood pressure and serum lipids in a population. The Tromso study. Circulation. 1991;83:1305–1314
[Abstract/Free Full Text] - Palatini P, Casiglia E, Pauletto P, Staessen J, Kaciroti N, Julius S. Relationship of tachycardia with high blood pressure and metabolic abnormalities: a study with mixture analysis in three populations. Hypertension. 1997;30:1267–1273
[Abstract/Free Full Text] - Arch Int Med. 1997;157:2413–2416
[Abstract/Free Full Text] - J Hypertens. 1999;17:151–183[Web of Science][Medline]
- National Cholesterol Education Program, Report of the Expert Panel on Population Strategies for Blood Cholesterol Reduction, 1990, NIH 90-3046
- Mensink GBM, Hoffmeister H. The relationship between resting heart rate and all-cause, cardiovascular and cancer mortality. Eur Heart J. 1997;18:1404–1410
[Abstract/Free Full Text] - Turner RC, Millns H, Neil HA. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ. 1998;316:823–828
[Abstract/Free Full Text] - J Hypertens. 1993;11:319–325[CrossRef][Web of Science][Medline]
- Neaton JD, Wentworth D. Serum cholesterol, blood pressure, cigarette smoking and death from coronary heart disease. Overall findings and differences by age for 316099 white men. Arch Int Med. 1992;152:56–64
[Abstract/Free Full Text] - Lowe LP, Greenland P, Ruth KJ, Dyer AR, Stamler R, Stamler J. Impact of major cardiovascular disease risk factors, particularly in combination, on 22-year mortality in women and men. Arch Int Med. 1998;158:2007–2014
[Abstract/Free Full Text] - Krumholz HM, Seeman TE, Merrill SS. Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortality in persons older than 70 years. JAMA. 1994;272:1335–1340
[Abstract/Free Full Text] - Thomas F, Guize L, Bean K, Benetos A. Combined effects of pulse pressure and heart rate on cardiovascular mortality. J Hypertens. 2001;19:863–869[CrossRef][Web of Science][Medline]
- Wld Hlth Stat Q. 1988;41:115–140
- Hypertension. 1985;7:641–651
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