High cholesterol levels are much more risky for middle-aged
men than middle-aged women when it comes to having a first heart attack, a new
study of more than 40 000 Norwegian men and women has shown.
The study, just published in the September issue of
Epidemiology, shows that being a middle-aged male and having high cholesterol
levels results in a negative synergistic effect that the researchers did not
observe in women. However, current
clinical guidelines for treating high cholesterol levels do not differentiate
between men and women.
"Our results suggest that in middle age, high
cholesterol levels are much more detrimental for men than women, so that
prevention efforts in this age group will have a greater potential to reduce
the occurrence of a first heart attack in men," said Erik Madssen from the
Norwegian University of Science and Technology's (NTNU) Department of Circulation and Medical
Imaging, who was first author of the paper with Lars Erik Laugsand, also from
The researchers used data from the second Nord-Trondelag
Health Study, a county-wide survey carried out in 1995-1997 in Nord-Trondelag,
Norway, that included blood sample collection from 65 000 people. Because the
researchers hypothesised that female sex hormones could possibly protect women
with respect to the prevalence of first heart attacks, they restricted their
analysis to participants who were younger than 60 years old at the time of the
In the end, the researchers had information from 23 525
women and 20 725 men who fit this category. During the nearly 12 years of
follow-up on the participants who were younger than 60 years when the survey
was conducted, there were 157 new cases of heart attacks in women and 553 in
They also conducted a secondary analysis of participants who
were 60 years old or older at the time of the survey, which gave them another
20 138 individuals for the analysis. However, there was no evidence of a
negative synergistic effect in male participants in this age group.
suggest that middle-aged men with an unfortunate cholesterol profile have a
significant additional risk of myocardial infarction than what was previously thought," Madssen and Laugsand said. "Thus, these men should be
treated more aggressively than what often is the case today, so that more
infarctions can be prevented and lives can be saved."