Martin M J, Hulley S B, Browner W S, Kuller L H, Wentworth D
Lancet. 1986 Oct 25;2(8513):933-6. doi: 10.1016/s0140-6736(86)90597-0.
The risks associated with various levels of serum cholesterol were determined by analysis of 6-year mortality in 361,662 men aged 35-57. Above the 20th percentile for serum cholesterol (greater than 181 mg/dl, greater than 4.68 mmol/l), coronary heart disease (CHD) mortality increased progressively; the relative risk was large (3.8) in the men with cholesterol levels above the 85th percentile (greater than 253 mg/dl, greater than 6.54 mmol/l). When men below the 20th cholesterol percentile were used as the baseline risk group, half of all CHD deaths were associated with raised serum cholesterol concentrations; half of these excess deaths were in men with cholesterol levels above the 85th percentile. For both CHD and total mortality, serum cholesterol was similar to diastolic blood pressure in the shape of the risk curve and in the size of the high-risk group. This new evidence supports the policy of a moderate fat intake for the general population and intensive treatment for those at high risk. There is a striking analogy between serum cholesterol and blood pressure in the epidemiological basis for identifying a large segment of the population (10-15%) for intensive treatment.
通过对361,662名年龄在35至57岁男性的6年死亡率进行分析，确定了与不同血清胆固醇水平相关的风险。血清胆固醇高于第20百分位数（大于181毫克/分升，大于4.68毫摩尔/升）时，冠心病（CHD）死亡率逐渐上升；在胆固醇水平高于第85百分位数（大于253毫克/分升，大于6.54毫摩尔/升）的男性中，相对风险很大（3.8）。以胆固醇水平低于第20百分位数的男性作为基线风险组时，所有冠心病死亡病例中有一半与血清胆固醇浓度升高有关；这些额外死亡病例中有一半发生在胆固醇水平高于第85百分位数的男性中。对于冠心病和总死亡率而言，血清胆固醇在风险曲线形状和高危人群规模方面与舒张压相似。这一新证据支持普通人群适度摄入脂肪以及对高危人群进行强化治疗的政策。在确定需强化治疗的大部分人群（10 - 15%）的流行病学基础方面，血清胆固醇和血压之间存在显著的相似之处。
