BMJ 1994;309:445-7 (13 August)

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Serum cholesterol concentration and mortality from accidents, suicide, and other violent causes

E Variainen, P Puska, J Pekkanen, J Tuomilehto, J Lonnqvist, C Ehnholm 

National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland Correspondence to: Erkki Vartiainen.

Abstract

Objective : To study the association of mortality from accidents, suicides, and other violent deaths with serum cholesterol concentration. Design - Baseline measurements in two randomly chosen independent cohorts were carried out in 1972 and 1977. Mortality was monitored over 10-15 years through the national death registry.
Setting : Eastern Finland.
Subjects : The two cohorts comprised men (n=10 898) and women (n=11 534) born between 1913 and 1947. There were 193 deaths due to accidents, suicides, and violence among men and 43 among women.
Main outcome measure : Mortality from accidents, suicides, and other violent deaths was used as the end point. Deaths from these causes were pooled together in the analyses.
Results : Serum cholesterol concentration was not associated with mortality from accidents, suicides, and other violent deaths in the univariate analyses or in the proportional hazards regression analyses including smoking, systolic blood pressure, alcohol drinking, and education. In both genders smoking was more prevalent among those who died from accidents, suicides, and other violent causes than from other causes. Frequent use of alcohol increased mortality from these causes.
Conclusion : The risk of accidents, suicides, and other violent deaths was not related to serum cholesterol concentration, whereas such deaths were more prevalent in smokers and alcohol drinkers.

Clinical implications

  • Clinical implications

  • Low total serum cholesterol concentration was not associated with increased mortality from accidents, suicides, or violence

  • Mortality from those causes was higher among smokers and increased gradually with the amount of daily smoking

  • Mortality was similar among those who had never smoked regularly and former smokers

  • Lowering serum cholesterol concentration in a population does not seem to increase accidents or violence


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