Is a high serum cholesterol level associated with longer survival in elderly hypertensives?

Jan Staessen, Antoon Amery, Willem Birkenhäger, Christopher Bulpitt, Denis Clement, Peter De Leeuw, Michel Deruyttere, André De Schaepdryver, Colin Dollery, Robert Fagard, Astrid Fletcher, Françoise Forette, Jill Forte, Jean François Flenry, Alan Koistinen, Gastone Leonetti, Aulikki Nissinen, Eoin O’Brien, Kevin O’Malley, Walter PelemansJames C. Petrie, Thomas K. Strasser, Laura Terzoli, Lutgarde Thijs, Jaakko Tuomilehto, John Webster, Brian O. Williams, P. Lund-Johansen, O. J. Ohm, P. Omvik, A. Alasoini, A. Koistinen, A. Nissinen, P. Puska, J. Tuomilehto, R. Varis, W. Birkenhäger, P. De Leeuw, P. Willemse, K. Beard, J. Dali, J. Macfarlane, B. O. Williams, T. A. Jeffers, J. C. Petrie, O. J. Robb, J. Webster, M. Laher, P. McCormack, F. Meagher, E. O'brien, W. O'callaghan, K. O'malley, C. J. Bulpitt, C. Dollery, A. E. Fletcher, P. Lewis, M. Murphy, R. C. Hamdy, N. H. Perera, X. Chellappah, J. Morris, A. I. Suchett-Kaye, H. Feltkamp, A. Konrads, U. Laaser, K. Meurer, A. Amery, R. Fagard, J. Hellemans, J. V. Joossens, P. Lijnen, W. Pelemans, J. Staessen, L. Thijs, R. Van Hoof, M. Bogaert, D. Clement, A. De Schaepdryver, P. Brixko, A. Ernould, A. Mutsers, J. F De Plaen, C. Van Ypersele, M. Deruyttere, P. Berthaux, F. Forette, J. F. Henry, G. Leonetti, X. Tammaro, L. Terzoli, A. Zanchetti, F. De Padua, J. Forte, J. M. Pereira-Miguel

Research output: Contribution to journalArticle

Abstract

The relationship between serum total cholesterol, measured at randomization, and mortality was investigated in 822 patients, who were followed for an average of 3.1 years in a double-blind trial, conducted by the European Working Party on High Blood Pressure in the Elderly. Serum cholesterol, measured at randomization, was 0.54 mmol/l higher in women than in men, and declined with increasing age in both men (0.028 mmol/l per year) and women (0.036 mmol/l per year). During follow-up on randomized treatment, cholesterol fell by a similar amount with placebo (0.11 mmol/l per year) and with active treatment (0.14mmol/l per year). Active treatment consisted of hydrochlorothiazide (25-50 mg/day) plus triamterene (50-100 mg/day) with the addition of a-methyldopa (0.5-2.0 g/day) in one-third of the patients. Serum total cholesterol, measured at randomization, was independently and inversely correlated with total (P = 0.03), non-cardiovascular (P = 0.03) and cancer (P = 0.04) mortality during follow-up on double-blind treatment. Total and non-cardiovascular mortality were also negatively correlated with haemoglobin and body weight at randomization. All factors being equal, an increase in serum total cholesterol by 2.3 mmol/l was associated with a 1-year prolongation of survival. However, after adjustment for gender, age, cardiovascular complications and systolic blood pressure at randomization, the correlations between serum cholesterol and cardiovascular and cardiac mortality were not significant. In conclusion, a high serum total cholesterol level is associated with longer survival in elderly hypertensives. This can be explained by the association of lower non-cardiovascular mortality with high serum cholesterol, and by the absence of a positive relationship in this population between cholesterol and cardiovascular mortality. However, recommendations for disease prevention must not be changed in the light of the present findings.

Original languageEnglish
Pages (from-to)755-761
Number of pages7
JournalJournal of Hypertension
Volume8
Issue number8
Publication statusPublished - 1990

Fingerprint

Hypercholesterolemia
Cholesterol
Survival
Random Allocation
Serum
Mortality
Triamterene
Blood Pressure
Methyldopa
Hydrochlorothiazide
Therapeutics
Hemoglobins
Placebos
Body Weight
Hypertension
Population

Keywords

  • Cholesterol
  • Elderly hypertension
  • Mortality
  • Risk factor

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Internal Medicine
  • Endocrinology

Cite this

Staessen, J., Amery, A., Birkenhäger, W., Bulpitt, C., Clement, D., Leeuw, P. D., ... Pereira-Miguel, J. M. (1990). Is a high serum cholesterol level associated with longer survival in elderly hypertensives? Journal of Hypertension, 8(8), 755-761.

Is a high serum cholesterol level associated with longer survival in elderly hypertensives? / Staessen, Jan; Amery, Antoon; Birkenhäger, Willem; Bulpitt, Christopher; Clement, Denis; Leeuw, Peter De; Deruyttere, Michel; Schaepdryver, André De; Dollery, Colin; Fagard, Robert; Fletcher, Astrid; Forette, Françoise; Forte, Jill; Flenry, Jean François; Koistinen, Alan; Leonetti, Gastone; Nissinen, Aulikki; O’Brien, Eoin; O’Malley, Kevin; Pelemans, Walter; Petrie, James C.; Strasser, Thomas K.; Terzoli, Laura; Thijs, Lutgarde; Tuomilehto, Jaakko; Webster, John; Williams, Brian O.; Lund-Johansen, P.; Ohm, O. J.; Omvik, P.; Alasoini, A.; Koistinen, A.; Nissinen, A.; Puska, P.; Tuomilehto, J.; Varis, R.; Birkenhäger, W.; Leeuw, P. De; Willemse, P.; Beard, K.; Dali, J.; Macfarlane, J.; Williams, B. O.; Jeffers, T. A.; Petrie, J. C.; Robb, O. J.; Webster, J.; Laher, M.; McCormack, P.; Meagher, F.; O'brien, E.; O'callaghan, W.; O'malley, K.; Bulpitt, C. J.; Dollery, C.; Fletcher, A. E.; Lewis, P.; Murphy, M.; Hamdy, R. C.; Perera, N. H.; Chellappah, X.; Morris, J.; Suchett-Kaye, A. I.; Feltkamp, H.; Konrads, A.; Laaser, U.; Meurer, K.; Amery, A.; Fagard, R.; Hellemans, J.; Joossens, J. V.; Lijnen, P.; Pelemans, W.; Staessen, J.; Thijs, L.; Hoof, R. Van; Bogaert, M.; Clement, D.; Schaepdryver, A. De; Brixko, P.; Ernould, A.; Mutsers, A.; Plaen, J. F De; Ypersele, C. Van; Deruyttere, M.; Berthaux, P.; Forette, F.; Henry, J. F.; Leonetti, G.; Tammaro, X.; Terzoli, L.; Zanchetti, A.; Padua, F. De; Forte, J.; Pereira-Miguel, J. M.

In: Journal of Hypertension, Vol. 8, No. 8, 1990, p. 755-761.

Research output: Contribution to journalArticle

Staessen, J, Amery, A, Birkenhäger, W, Bulpitt, C, Clement, D, Leeuw, PD, Deruyttere, M, Schaepdryver, AD, Dollery, C, Fagard, R, Fletcher, A, Forette, F, Forte, J, Flenry, JF, Koistinen, A, Leonetti, G, Nissinen, A, O’Brien, E, O’Malley, K, Pelemans, W, Petrie, JC, Strasser, TK, Terzoli, L, Thijs, L, Tuomilehto, J, Webster, J, Williams, BO, Lund-Johansen, P, Ohm, OJ, Omvik, P, Alasoini, A, Koistinen, A, Nissinen, A, Puska, P, Tuomilehto, J, Varis, R, Birkenhäger, W, Leeuw, PD, Willemse, P, Beard, K, Dali, J, Macfarlane, J, Williams, BO, Jeffers, TA, Petrie, JC, Robb, OJ, Webster, J, Laher, M, McCormack, P, Meagher, F, O'brien, E, O'callaghan, W, O'malley, K, Bulpitt, CJ, Dollery, C, Fletcher, AE, Lewis, P, Murphy, M, Hamdy, RC, Perera, NH, Chellappah, X, Morris, J, Suchett-Kaye, AI, Feltkamp, H, Konrads, A, Laaser, U, Meurer, K, Amery, A, Fagard, R, Hellemans, J, Joossens, JV, Lijnen, P, Pelemans, W, Staessen, J, Thijs, L, Hoof, RV, Bogaert, M, Clement, D, Schaepdryver, AD, Brixko, P, Ernould, A, Mutsers, A, Plaen, JFD, Ypersele, CV, Deruyttere, M, Berthaux, P, Forette, F, Henry, JF, Leonetti, G, Tammaro, X, Terzoli, L, Zanchetti, A, Padua, FD, Forte, J & Pereira-Miguel, JM 1990, 'Is a high serum cholesterol level associated with longer survival in elderly hypertensives?', Journal of Hypertension, vol. 8, no. 8, pp. 755-761.
Staessen J, Amery A, Birkenhäger W, Bulpitt C, Clement D, Leeuw PD et al. Is a high serum cholesterol level associated with longer survival in elderly hypertensives? Journal of Hypertension. 1990;8(8):755-761.
Staessen, Jan ; Amery, Antoon ; Birkenhäger, Willem ; Bulpitt, Christopher ; Clement, Denis ; Leeuw, Peter De ; Deruyttere, Michel ; Schaepdryver, André De ; Dollery, Colin ; Fagard, Robert ; Fletcher, Astrid ; Forette, Françoise ; Forte, Jill ; Flenry, Jean François ; Koistinen, Alan ; Leonetti, Gastone ; Nissinen, Aulikki ; O’Brien, Eoin ; O’Malley, Kevin ; Pelemans, Walter ; Petrie, James C. ; Strasser, Thomas K. ; Terzoli, Laura ; Thijs, Lutgarde ; Tuomilehto, Jaakko ; Webster, John ; Williams, Brian O. ; Lund-Johansen, P. ; Ohm, O. J. ; Omvik, P. ; Alasoini, A. ; Koistinen, A. ; Nissinen, A. ; Puska, P. ; Tuomilehto, J. ; Varis, R. ; Birkenhäger, W. ; Leeuw, P. De ; Willemse, P. ; Beard, K. ; Dali, J. ; Macfarlane, J. ; Williams, B. O. ; Jeffers, T. A. ; Petrie, J. C. ; Robb, O. J. ; Webster, J. ; Laher, M. ; McCormack, P. ; Meagher, F. ; O'brien, E. ; O'callaghan, W. ; O'malley, K. ; Bulpitt, C. J. ; Dollery, C. ; Fletcher, A. E. ; Lewis, P. ; Murphy, M. ; Hamdy, R. C. ; Perera, N. H. ; Chellappah, X. ; Morris, J. ; Suchett-Kaye, A. I. ; Feltkamp, H. ; Konrads, A. ; Laaser, U. ; Meurer, K. ; Amery, A. ; Fagard, R. ; Hellemans, J. ; Joossens, J. V. ; Lijnen, P. ; Pelemans, W. ; Staessen, J. ; Thijs, L. ; Hoof, R. Van ; Bogaert, M. ; Clement, D. ; Schaepdryver, A. De ; Brixko, P. ; Ernould, A. ; Mutsers, A. ; Plaen, J. F De ; Ypersele, C. Van ; Deruyttere, M. ; Berthaux, P. ; Forette, F. ; Henry, J. F. ; Leonetti, G. ; Tammaro, X. ; Terzoli, L. ; Zanchetti, A. ; Padua, F. De ; Forte, J. ; Pereira-Miguel, J. M. / Is a high serum cholesterol level associated with longer survival in elderly hypertensives?. In: Journal of Hypertension. 1990 ; Vol. 8, No. 8. pp. 755-761.
@article{37e8f19acb644ebba1d153e284f2a2e3,
title = "Is a high serum cholesterol level associated with longer survival in elderly hypertensives?",
abstract = "The relationship between serum total cholesterol, measured at randomization, and mortality was investigated in 822 patients, who were followed for an average of 3.1 years in a double-blind trial, conducted by the European Working Party on High Blood Pressure in the Elderly. Serum cholesterol, measured at randomization, was 0.54 mmol/l higher in women than in men, and declined with increasing age in both men (0.028 mmol/l per year) and women (0.036 mmol/l per year). During follow-up on randomized treatment, cholesterol fell by a similar amount with placebo (0.11 mmol/l per year) and with active treatment (0.14mmol/l per year). Active treatment consisted of hydrochlorothiazide (25-50 mg/day) plus triamterene (50-100 mg/day) with the addition of a-methyldopa (0.5-2.0 g/day) in one-third of the patients. Serum total cholesterol, measured at randomization, was independently and inversely correlated with total (P = 0.03), non-cardiovascular (P = 0.03) and cancer (P = 0.04) mortality during follow-up on double-blind treatment. Total and non-cardiovascular mortality were also negatively correlated with haemoglobin and body weight at randomization. All factors being equal, an increase in serum total cholesterol by 2.3 mmol/l was associated with a 1-year prolongation of survival. However, after adjustment for gender, age, cardiovascular complications and systolic blood pressure at randomization, the correlations between serum cholesterol and cardiovascular and cardiac mortality were not significant. In conclusion, a high serum total cholesterol level is associated with longer survival in elderly hypertensives. This can be explained by the association of lower non-cardiovascular mortality with high serum cholesterol, and by the absence of a positive relationship in this population between cholesterol and cardiovascular mortality. However, recommendations for disease prevention must not be changed in the light of the present findings.",
keywords = "Cholesterol, Elderly hypertension, Mortality, Risk factor",
author = "Jan Staessen and Antoon Amery and Willem Birkenh{\"a}ger and Christopher Bulpitt and Denis Clement and Leeuw, {Peter De} and Michel Deruyttere and Schaepdryver, {Andr{\'e} De} and Colin Dollery and Robert Fagard and Astrid Fletcher and Fran{\cc}oise Forette and Jill Forte and Flenry, {Jean Fran{\cc}ois} and Alan Koistinen and Gastone Leonetti and Aulikki Nissinen and Eoin O’Brien and Kevin O’Malley and Walter Pelemans and Petrie, {James C.} and Strasser, {Thomas K.} and Laura Terzoli and Lutgarde Thijs and Jaakko Tuomilehto and John Webster and Williams, {Brian O.} and P. Lund-Johansen and Ohm, {O. J.} and P. Omvik and A. Alasoini and A. Koistinen and A. Nissinen and P. Puska and J. Tuomilehto and R. Varis and W. Birkenh{\"a}ger and Leeuw, {P. De} and P. Willemse and K. Beard and J. Dali and J. Macfarlane and Williams, {B. O.} and Jeffers, {T. A.} and Petrie, {J. C.} and Robb, {O. J.} and J. Webster and M. Laher and P. McCormack and F. Meagher and E. O'brien and W. O'callaghan and K. O'malley and Bulpitt, {C. J.} and C. Dollery and Fletcher, {A. E.} and P. Lewis and M. Murphy and Hamdy, {R. C.} and Perera, {N. H.} and X. Chellappah and J. Morris and Suchett-Kaye, {A. I.} and H. Feltkamp and A. Konrads and U. Laaser and K. Meurer and A. Amery and R. Fagard and J. Hellemans and Joossens, {J. V.} and P. Lijnen and W. Pelemans and J. Staessen and L. Thijs and Hoof, {R. Van} and M. Bogaert and D. Clement and Schaepdryver, {A. De} and P. Brixko and A. Ernould and A. Mutsers and Plaen, {J. F De} and Ypersele, {C. Van} and M. Deruyttere and P. Berthaux and F. Forette and Henry, {J. F.} and G. Leonetti and X. Tammaro and L. Terzoli and A. Zanchetti and Padua, {F. De} and J. Forte and Pereira-Miguel, {J. M.}",
year = "1990",
language = "English",
volume = "8",
pages = "755--761",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Is a high serum cholesterol level associated with longer survival in elderly hypertensives?

AU - Staessen, Jan

AU - Amery, Antoon

AU - Birkenhäger, Willem

AU - Bulpitt, Christopher

AU - Clement, Denis

AU - Leeuw, Peter De

AU - Deruyttere, Michel

AU - Schaepdryver, André De

AU - Dollery, Colin

AU - Fagard, Robert

AU - Fletcher, Astrid

AU - Forette, Françoise

AU - Forte, Jill

AU - Flenry, Jean François

AU - Koistinen, Alan

AU - Leonetti, Gastone

AU - Nissinen, Aulikki

AU - O’Brien, Eoin

AU - O’Malley, Kevin

AU - Pelemans, Walter

AU - Petrie, James C.

AU - Strasser, Thomas K.

AU - Terzoli, Laura

AU - Thijs, Lutgarde

AU - Tuomilehto, Jaakko

AU - Webster, John

AU - Williams, Brian O.

AU - Lund-Johansen, P.

AU - Ohm, O. J.

AU - Omvik, P.

AU - Alasoini, A.

AU - Koistinen, A.

AU - Nissinen, A.

AU - Puska, P.

AU - Tuomilehto, J.

AU - Varis, R.

AU - Birkenhäger, W.

AU - Leeuw, P. De

AU - Willemse, P.

AU - Beard, K.

AU - Dali, J.

AU - Macfarlane, J.

AU - Williams, B. O.

AU - Jeffers, T. A.

AU - Petrie, J. C.

AU - Robb, O. J.

AU - Webster, J.

AU - Laher, M.

AU - McCormack, P.

AU - Meagher, F.

AU - O'brien, E.

AU - O'callaghan, W.

AU - O'malley, K.

AU - Bulpitt, C. J.

AU - Dollery, C.

AU - Fletcher, A. E.

AU - Lewis, P.

AU - Murphy, M.

AU - Hamdy, R. C.

AU - Perera, N. H.

AU - Chellappah, X.

AU - Morris, J.

AU - Suchett-Kaye, A. I.

AU - Feltkamp, H.

AU - Konrads, A.

AU - Laaser, U.

AU - Meurer, K.

AU - Amery, A.

AU - Fagard, R.

AU - Hellemans, J.

AU - Joossens, J. V.

AU - Lijnen, P.

AU - Pelemans, W.

AU - Staessen, J.

AU - Thijs, L.

AU - Hoof, R. Van

AU - Bogaert, M.

AU - Clement, D.

AU - Schaepdryver, A. De

AU - Brixko, P.

AU - Ernould, A.

AU - Mutsers, A.

AU - Plaen, J. F De

AU - Ypersele, C. Van

AU - Deruyttere, M.

AU - Berthaux, P.

AU - Forette, F.

AU - Henry, J. F.

AU - Leonetti, G.

AU - Tammaro, X.

AU - Terzoli, L.

AU - Zanchetti, A.

AU - Padua, F. De

AU - Forte, J.

AU - Pereira-Miguel, J. M.

PY - 1990

Y1 - 1990

N2 - The relationship between serum total cholesterol, measured at randomization, and mortality was investigated in 822 patients, who were followed for an average of 3.1 years in a double-blind trial, conducted by the European Working Party on High Blood Pressure in the Elderly. Serum cholesterol, measured at randomization, was 0.54 mmol/l higher in women than in men, and declined with increasing age in both men (0.028 mmol/l per year) and women (0.036 mmol/l per year). During follow-up on randomized treatment, cholesterol fell by a similar amount with placebo (0.11 mmol/l per year) and with active treatment (0.14mmol/l per year). Active treatment consisted of hydrochlorothiazide (25-50 mg/day) plus triamterene (50-100 mg/day) with the addition of a-methyldopa (0.5-2.0 g/day) in one-third of the patients. Serum total cholesterol, measured at randomization, was independently and inversely correlated with total (P = 0.03), non-cardiovascular (P = 0.03) and cancer (P = 0.04) mortality during follow-up on double-blind treatment. Total and non-cardiovascular mortality were also negatively correlated with haemoglobin and body weight at randomization. All factors being equal, an increase in serum total cholesterol by 2.3 mmol/l was associated with a 1-year prolongation of survival. However, after adjustment for gender, age, cardiovascular complications and systolic blood pressure at randomization, the correlations between serum cholesterol and cardiovascular and cardiac mortality were not significant. In conclusion, a high serum total cholesterol level is associated with longer survival in elderly hypertensives. This can be explained by the association of lower non-cardiovascular mortality with high serum cholesterol, and by the absence of a positive relationship in this population between cholesterol and cardiovascular mortality. However, recommendations for disease prevention must not be changed in the light of the present findings.

AB - The relationship between serum total cholesterol, measured at randomization, and mortality was investigated in 822 patients, who were followed for an average of 3.1 years in a double-blind trial, conducted by the European Working Party on High Blood Pressure in the Elderly. Serum cholesterol, measured at randomization, was 0.54 mmol/l higher in women than in men, and declined with increasing age in both men (0.028 mmol/l per year) and women (0.036 mmol/l per year). During follow-up on randomized treatment, cholesterol fell by a similar amount with placebo (0.11 mmol/l per year) and with active treatment (0.14mmol/l per year). Active treatment consisted of hydrochlorothiazide (25-50 mg/day) plus triamterene (50-100 mg/day) with the addition of a-methyldopa (0.5-2.0 g/day) in one-third of the patients. Serum total cholesterol, measured at randomization, was independently and inversely correlated with total (P = 0.03), non-cardiovascular (P = 0.03) and cancer (P = 0.04) mortality during follow-up on double-blind treatment. Total and non-cardiovascular mortality were also negatively correlated with haemoglobin and body weight at randomization. All factors being equal, an increase in serum total cholesterol by 2.3 mmol/l was associated with a 1-year prolongation of survival. However, after adjustment for gender, age, cardiovascular complications and systolic blood pressure at randomization, the correlations between serum cholesterol and cardiovascular and cardiac mortality were not significant. In conclusion, a high serum total cholesterol level is associated with longer survival in elderly hypertensives. This can be explained by the association of lower non-cardiovascular mortality with high serum cholesterol, and by the absence of a positive relationship in this population between cholesterol and cardiovascular mortality. However, recommendations for disease prevention must not be changed in the light of the present findings.

KW - Cholesterol

KW - Elderly hypertension

KW - Mortality

KW - Risk factor

UR - http://www.scopus.com/inward/record.url?scp=0025041877&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025041877&partnerID=8YFLogxK

M3 - Article

C2 - 2170516

AN - SCOPUS:0025041877

VL - 8

SP - 755

EP - 761

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 8

ER -