Traditional risk-factor profile fails to explain striking geographical differences in IHD mortality among middle-aged men. The project "myocardial infarction in mid-Sweden".

An east-west gradient in cardiovascular mortality has been reported from the region of mid-Sweden. Postal questionnaire studies found that the risk factor distributions among middle-aged men were similar in areas with striking differences in cardiovascular mortality. In this study, 120 randomly selected 50-year-old men in two high mortality communities in the west and 120 men from two low mortality communities in the east were invited to a health survey in which serum lipids and other risk factors were analysed. Total serum cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride levels were similar. Among fatty acids, stearic acid was high and arachidonic acid was low in the high mortality area. The levels of other traditional risk factors were the same. After taking these differences into account, the mortality differences remain large.