October 1, 1981
View Full PaperSmoking, blood pressure and serum cholesterol as risk factors of acute myocardial infaction and death among men in Eastern Finland
Key Result
Smoking, systolic blood pressure ≥160 mm Hg, and serum cholesterol ≥8 mmol/l were associated with up to a 2- to 3-fold increased risk of acute myocardial infarction and death (P<0.05).
Study Design
Type
Cohort (n=4,034)
Multicenter
Yes
Structured PICO
Do smoking, elevated blood pressure, and elevated serum cholesterol increase the risk of acute myocardial infarction and death in middle-aged men?
P
Population
4,034 men aged 35 to 59 years from Eastern Finland followed for 5 years to assess risk factors for acute myocardial infarction and death.
E
Exposure
Exposure to risk factors: smoking, elevated systolic blood pressure (≥160 mm Hg), and elevated serum cholesterol (≥8 mmol/l).
C
Comparator
Absence of these risk factors (non-smokers, lower blood pressure, lower serum cholesterol).
O
Outcome
Acute myocardial infarction, all-cause death, and cardiovascular death at 5 years follow-up.hard clinical
Smoking, elevated systolic blood pressure, and elevated serum cholesterol are significant independent and joint risk factors for acute myocardial infarction and mortality in middle-aged men.
Main Result
Effect estimate: RR 2-3 for smoking on AMI; RR 2.6 for cholesterol ≥8 mmol/l on AMI
p-value: p=< 0.05
Abstract
The impact of smoking, serum cholesterol and blood pressure on the risk of acute myocardial infarction and death due to all causes and cardiovascular diseases was studied in a random sample of men aged 35 to 59 years from the North Karelia and Kuopio counties of Eastern Finland. This is an area with an exceptionally high incidence of coronary heart disease. Altogether, 4034 men were studied with a participation rate of 92%. These men were followed-up with a myocardial infarction register and death certificate data. During the first five years 256 deaths occurred among all subjects. There were 66 acute myocardial infarctions in the North Karelian men reporting no recent coronary heart disease. Smoking, elevated serum cholesterol and blood pressure were independently and jointly related to an increased risk of acute myocardial infarction and death due to all causes and to cardiovascular disease. Smokers had a 2–3-fold age-adjusted risk of acute myocardial infarction, a 2-2-fold risk of any death and a 2.1-fold risk of cardiovascular death compared with non-smokers. The age-adjusted risk ratios for systolic blood pressure of 160 mm Hg or more were 1.3, 1.4 and 1.9 and those for serum cholesterol at least 8 mmol/l (309 mg/100 ml) 2.6, 1.5 and 2.6 concerning myocardial infarction, all deaths and cardiovascular deaths, respectively. All risk ratios except that of systolic blood pressure for acute myocardial infarction were significant at levels of at least P < 0.05