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BMJ. Aug 1, 1992; 305(6848): 277–279.
PMCID: PMC1882740

Low serum cholesterol concentration and short term mortality from injuries in men and women.


OBJECTIVE--To determine whether total serum cholesterol concentration predicts mortality from injuries including suicide. DESIGN--Cohort study of men and women who had their serum cholesterol concentration measured as part of a general health survey in Värmland, Sweden in 1964 or 1965 and were followed up for an average of 20.5 years. SUBJECTS--Adults participating in health screening in 1964-5 (26,693 men and 27,692 women). The study sample was restricted to subjects aged 45-74 years during any of the 20.5 years of follow-up. MAIN OUTCOME MEASURES--Serum cholesterol concentration. Deaths from all injuries and suicides during three periods of follow up (0-6 years, 7-13 years, and 14-21 years) according to the Swedish mortality register in subjects aged 45-74. Adjustment was made for prevalent cancer (identified from the Swedish cancer register) at the time of a suicide. RESULTS--A strong negative relation between cholesterol concentration and mortality from injuries was found in men during the first seven years of follow up. The relative risk in the lowest 25% of the cholesterol distribution was 2.8 (95% confidence interval 1.52 to 4.96) compared with the top 25%. Most of the excess risk was caused by suicide with a corresponding relative risk of 4.2 (p for trend = 0.001). Correction for prevalent cancer did not change the results. Events occurring during the latter two thirds of the 20.5 years of follow up were not predicted. In women no relation between cholesterol concentration and mortality from injuries was found. CONCLUSIONS--Together with observations from intervention trials the findings support the existence of a relation between serum cholesterol concentration and suicide. The causality of such a relation is, however, not resolved.

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Selected References

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  • Davey Smith G, Pekkanen J. Should there be a moratorium on the use of cholesterol lowering drugs? BMJ. 1992 Feb 15;304(6824):431–434. [PMC free article] [PubMed]
  • Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalmi P, Helo P, Huttunen JK, Kaitaniemi P, Koskinen P, Manninen V, et al. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med. 1987 Nov 12;317(20):1237–1245. [PubMed]
  • Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ. 1990 Aug 11;301(6747):309–314. [PMC free article] [PubMed]
  • Pekkanen J, Nissinen A, Punsar S, Karvonen MJ. Serum cholesterol and risk of accidental or violent death in a 25-year follow-up. The Finnish cohorts of the Seven Countries Study. Arch Intern Med. 1989 Jul;149(7):1589–1591. [PubMed]
  • Lowering cholesterol concentrations and mortality. BMJ. 1990 Sep 15;301(6751):552–555. [PMC free article] [PubMed]
  • Törnberg SA, Holm LE, Carstensen JM, Eklund GA. Cancer incidence and cancer mortality in relation to serum cholesterol. J Natl Cancer Inst. 1989 Dec 20;81(24):1917–1921. [PubMed]
  • Lindberg G, Eklund GA, Gullberg B, Råstam L. Serum sialic acid concentration and cardiovascular mortality. BMJ. 1991 Jan 19;302(6769):143–146. [PMC free article] [PubMed]
  • ZAK B, DICKENMAN RC, WHITE EG, BURNETT H, CHERNEY PJ. Rapid estimation of free and total cholesterol. Am J Clin Pathol. 1954 Nov;24(11):1307–1315. [PubMed]
  • Mattsson B, Wallgren A. Completeness of the Swedish Cancer Register. Non-notified cancer cases recorded on death certificates in 1978. Acta Radiol Oncol. 1984;23(5):305–313. [PubMed]
  • Chen Z, Peto R, Collins R, MacMahon S, Lu J, Li W. Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. BMJ. 1991 Aug 3;303(6797):276–282. [PMC free article] [PubMed]
  • Lindberg G, Råstam L, Gullberg B, Eklund GA. Serum sialic acid concentration predicts both coronary heart disease and stroke mortality: multivariate analysis including 54,385 men and women during 20.5 years follow-up. Int J Epidemiol. 1992 Apr;21(2):253–257. [PubMed]
  • Gordon T, Doyle JT. Alcohol consumption and its relationship to smoking, weight, blood pressure, and blood lipids. The Albany Study. Arch Intern Med. 1986 Feb;146(2):262–265. [PubMed]
  • Friedman LA, Kimball AW. Coronary heart disease mortality and alcohol consumption in Framingham. Am J Epidemiol. 1986 Sep;124(3):481–489. [PubMed]
  • Virkkunen M, Penttinen H. Serum cholesterol in aggressive conduct disorder: a preliminary study. Biol Psychiatry. 1984 Mar;19(3):435–439. [PubMed]
  • Virkkunen M. Serum cholesterol in antisocial personality. Neuropsychobiology. 1979;5(1):27–30. [PubMed]
  • Jenkins CD, Hames CG, Zyzanski SJ, Rosenman RH, Friedman M. Psychological traits and serum lipids. I. Findings from the California Psychological Inventory. Psychosom Med. 1969 Mar-Apr;31(2):115–128. [PubMed]

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