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Plasma cholesterol concentration and mortality. The Whitehall Study.

G D Smith¹, M J Shipley, M G Marmot

¹Department of Epidemiology and Population Sciences, London, England.

|January 1, 1992

Summary

Low plasma cholesterol levels may be linked to other health factors that increase mortality risk, not cholesterol itself. This study examined cholesterol and death causes in male civil servants over 18 years.

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Area of Science:

Epidemiology
Cardiovascular Health
Public Health

Background:

Plasma cholesterol concentration is a known risk factor for cardiovascular disease.
Previous cohort studies have suggested inverse associations between cholesterol and certain causes of death.
Understanding these associations is crucial for accurate risk assessment and public health guidance.

Purpose of the Study:

To investigate the relationship between plasma cholesterol levels and mortality from major causes of death.
To explore potential confounding factors that may influence the observed associations.
To clarify the role of cholesterol in overall mortality risk.

Main Methods:

A cohort study design was employed, involving 17,718 male civil servants aged 40-64.
Data were collected between 1967 and 1969, with mortality tracked over an 18-year follow-up period.
Mortality from major cause groups, including coronary heart disease, cancer, and respiratory diseases, was the main outcome measure.

Main Results:

Total mortality increased with higher cholesterol levels, but very low levels showed nonsignificantly higher mortality.
Coronary heart disease mortality showed a significant positive trend with increasing cholesterol concentration.
Inverse associations were observed between cholesterol and mortality from lung cancer, non-neoplastic respiratory disease, and smoking-related cancers, but these were largely explained by other health and socioeconomic factors.

Conclusions:

The inverse relationship between plasma cholesterol and mortality from certain causes may be attributed to confounding factors.
Participants with low cholesterol levels may have underlying characteristics that elevate their risk of death.
These findings highlight the importance of considering a comprehensive health profile beyond cholesterol levels for accurate mortality risk prediction.