Relation of lipids, weight and physical activity to incidence of coronary heart disease: the Puerto Rico heart study.

The 2 1/2 year incidence of coronary heart disease was examined in relation to antecedent serum cholesterol and fasting triglyceride levels, physical activity status and relative weight in a cohort of 8,171 urban and rural men 45 to 64 years old participating in the Puerto Rico Heart Program. In this population with a low incidence rate of coronary heart disease, risk of coronary disease was related to serum cholesterol in both urban and rural groups, but this trend was statistically significant only in the urban population. Neither the urban nor the rural population showed a substantial or statistically significant association of serum triglyceride levels with incidence of coronary heart disease. Correlations among relative weight and serum triglyceride and serum cholesterol levels were noted. Despite small differences in incidence of coronary heart disease between urban and rural groups, values for serum cholesterol, triglycerides and relative weight were all significantly higher in the urban men. Only physical activity levels were higher in the rural men. Multivariate analysis, performed to sort out the net effects of these interrelated variables, revealed that serum cholesterol is related to the risk of coronary heart disease even when all variables are taken into account. Low levels of physical activity were significantly associated with a greater incidence of coronary heart disease only in urban men (P less than 0.05). Overweight, which was associated with higher lipid values and less physical activity, was not related to the development of coronary heart disease in either the urban or the rural cohort.