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Review: lower total cholesterol is associated with reduced risk of death from ischaemic heart disease but not stroke

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P S C secretariat

Correspondence to: P S C secretariat, University of Oxford, Oxford, UK;


What is the relation between blood cholesterol concentrations and vascular mortality?


Studies selected evaluated blood pressure (BP), blood cholesterol, age, and sex at baseline and cause and date of death at follow-up, and had >5000 person-years of follow-up. Studies of patients with a history of stroke or heart disease were excluded. Outcome was vascular death (ischaemic heart disease [IHD], stroke, and other).


Medline, EMBASE/Excerpta Medica, and meeting abstracts were searched for prospective cohort studies, and study investigators were contacted. 61 studies (n = 892 337, mean follow-up 13 y) were included. Analyses used individual patient data and were adjusted for patient age and sex and study; patients with a history of stroke or heart disease at baseline were excluded, and those …

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  • Source of funding: UK Medical Research Council; British Heart Foundation; EU BIOMED programme; NIA/NIH; Merck.