Influence of serum triglyceride levels on the risk for myocardial infarction in 12,510 middle aged males: interaction with serum cholesterol.

OBJECTIVE

To study the influence of different levels of serum (s)-triglycerides in relation to s-cholesterol on the risk of myocardial infarction.

METHODS

A 6-13 (mean 10) year follow-up of 12,510 middle-aged men. Fasting s-triglycerides and s-cholesterol were measured at the screening examination.

METHODS

Section of Preventive Medicine at the Department of Internal Medicine, Malmö General Hospital, an urban hospital for 240,000 inhabitants in southern Sweden.

METHODS

In minor groups of patients there were interventions addressing high lipid levels, high alcohol consumption, hypertension and glucose intolerance.

METHODS

Myocardial infarction was used as an end-point.

RESULTS

446 myocardial infarctions occurred. The cumulative incidence rates were for the lowest triglyceride quartile 1.2%, for the second 3.2%, for the third 4.1% and for the highest 5.6%. After adjustment for age, year of screening, body mass index, diabetes, smoking, hypertension and s-cholesterol there was a significant relationship between triglycerides and the relative risk for myocardial infarction (P for trend=0.0087). For increasing levels of triglycerides, adjusted for the above factors except cholesterol, the impact of a certain cholesterol value for the occurrence of myocardial infarction was increased (P for trend=0.0092).

CONCLUSIONS

The present study emphasizes the interaction between cholesterol and triglyceride values for the risk of myocardial infarction. It is concluded that at triglyceride values above 1.0 mmol/l and cholesterol above 6.8 mmol/l there is an increasing interaction between cholesterol and triglyceride levels that might be of importance when evaluating the cardiovascular risk of middle aged men.