Læknablaðið - 15.08.1990, Blaðsíða 40

306
LÆKNABLAÐIÐ
these studies have been carried out on middle aged
men. The results, however, have been interpreted
as being also pertinent for women. The aim of
this study was to investigate blood lipids as risk
factors for CHD in women as studied both cross-
sectionally and longitudinally.
The population sample studied initially 1968-69
comprised 1462 women living in Göteborg at that
time (participation rate 90.1%). They were selected
according to certain age strata and predetermined
birthdates divisible by six. The women were
restudied six and 12 years later. In the cross-
sectional study of myocardial infarction in woraen,
women in the population study were used as a
control group and compared with all women who
survived MI in Göteborg during the period 1968-
70. The longitudinal follow-up is still going on,
especially regarding causes of death. 24- year
follow-up is planned for 1992-93.
Studied cross-sectionally, there was a significant
over- representation of women with M1 who had
triglyceride values above the median values of
the population sample. The cholesterol values of
women with MI, however, were no higher than
in the general population of women. Studied
longitudinally it was found that women who
had initial triglyceride values >2.2 mmol/1 had
significantly increased risk for MI, stroke and death
of all causes. In women with initial cholesterol
levels > 8.0 mmol/1 only a trend for MI was seen.
This, however, was not confirmed in multivariate
analysis for cholesterol, but was still strongly
positive for triglycerides after taking cholesterol
into account as a confounding factor. The waste to
hip ratio greater than 0.8 was also shown to be an
independend risk factor for CHD in women.
We conclude that elevation of serum triglycerides
is the main lipid risk factor for CHD in women,
and that elevated serum cholesterol is of minor
importance.
HEIMILDIR
1. Expert Panel on Detection, Evaluation, and Treatment
of High Blood Cholesterol in Adults. Report of the
National Cholesterol Education Program Expert Panel
on Detection, Evaluation, and Treatment of High
Blood Cholesterol in Adults. Arch Intem Med 1988;
148: 36-69.
2. National Board of Health and Welfare Drug
Införmation Committee, Sweden. Treatment of
hyperlipidemia. Uppsala 1989.
3. Bengtsson C, Blohmé G, Hallberg L, Hallström T,
Isaksson B, Korsan-Bengtsen K, Rybo G, Tibblin E,
Tibblin G, Westcrberg H. The study of women in
Gothenburg 1968-69 - a population study. General
design, purpose and sampling results. Acta Med
Scand 1973; 193: .311-8.
4. Bengtsson C. Ischaemic heart disease in women. A
study based on a randomized population sample of
women and women with myocardial infarction in
Göteborg, Sweden. Acta Med Scand 1973; Suppl 549.
5. Sigurdsson JA. High blood pressure in women. A
cross-sectional and a longitudinal follow-up study.
Acta Med Scand 1983; Suppl 669.
6. Bengtsson C, Gredmark T, Hallberg L, Hallström
T, Isaksson B, Lapidus L, Lindquist O, Lindstedt
S, Lurie M, Nyström E, Rybo G, Samuelsson S,
Rafnsson V, Sigurdsson JA. The population study
of women in Gothenburg 1980-81 - the third phase
of a longitudinal study. Scand J Soc Med 1989: 17:
141-5.
7. Lapidus L. Ischaemic heart disease, stroke and total
mortality in women. Results from a prospective
population study in Gothenburg, Sweden. Acta Med
Scand 1986; Suppl 705.
8. Johansson S, Bondjers G, Fager G, et al. Serum
lipids and apolipoprotein levels in women with acute
myocardial infarction. Arteriosclerosis 1988; 8: 742-9.
9. Carlson LA, Böttiger LE. Risk factors for ischaemic
heart disease in men and women. Results of the 19-
year follow-up of the Stockholm Prospective Study.
Acta Med Scand 1985; 218: 207-11.
10. Heyden S, Heiss G, Hames CG, Bartel AG. Fasting
triglycerides as predictors of total and CHD mortality
in Evans County, Georgia. J Chron Dis 1980; 33:
275-82.
11. Epstein FH. Some uses of prospective observations in
the Tecumseh Community Health Study. Proc R Soc
Med 1967; 60: 56-60.
12. Castelli WP. The triglyceride issue: A view from
Framingham. Am Heart J 1986; 112: 432-7.
13. Lapidus L, Bengtsson C, Lindquist O, Sigurdsson
JA, Rybo E. Triglycerides - main lipid risk factor for
cardiovascular disease in women? Acta Med Scand
1985; 217: 481-9.
14. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo
E, Sjöström L. Distribution of adipose tissue and risk
of cardiovascular disease and death: a 12 year follow
up of participants in the populations study of women
in Gothenburg, Sweden. Br Med J 1984; 289: 1257-
61.
15. Lapidus L, Bengtsson C, Blohmé G, Lindquist
O, Nyström E. Blood glucose, glucose tolerance
and manifest diabetes in relation to cardiovascular
disease and death in women. A 12-year follow-up
of participants in the population study of women in
Gothenburg, Sweden. Acta Med Scand 1985; 218:
455-62.
16. The Pooling Project Reseach Group. Relationship
of blood pressure, serum cholesterol, smoking habit,
relative weight and ECG abnormalities to incidence
of major coronary events: final report of the Pooling
Project. J Chron Dis 1978; 31: 201-306.
17. Wilhelmsen L, Wedel H, Tibblin G. Multivariate
analysis of risk factors for coronary heart disease.
Circulation 1973; 48: 950-8.
18. Welin L, Larsson B, Svardsudd K, Eriksson
H, Wilhelmsen L, Tibblin G. Triglycerider,
en kontroversiell riskfaktor för hjartinfarkt.
Nya fynd frán studien »1913 árs mán«.
Svenska Lákaresállskapets Riksstámma 1988;
Sammanfattningar, 185-6.
19. Bjömsson OJ, Davíðsson D, Kristjánsson BÞ,
Sigfússon N, Þorsteinsson Þ. Serum total cholesterol
and triglycerides in females aged 34-61 years. Health
survey in the Reykjavík area. Report a XI. Reykjavík
1988.