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American Journal of Epidemiology Vol. 121, No. 1: 19-30
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health

research-article

THE ASSOCIATION BETWEEN CHOLESTEROL CHOLELITHIASIS AND CORONARY HEART DISEASE IN FRAMINGHAM, MASSACHUSETTS

EDWARD A. BORTNICHAK1, DANIEL H. FREEMAN, JR.2, ADRIAN M. OSTFELD2, WILLIAM P. CASTELLI3, WILLIAM B. KANNEL4, MANNING FEINLEIB5 and PATRICIA M. MCNAMARA3

1Pfizer International Inc. 235 East 42nd Street, New York, NY 10017. (Reprint requests to Dr. Bortnichak.)
2Yale University School of Medicine, Department of Epidemiology and Public Health New Haven, CT
3Framingham Heart Study Framingham, MA
4Boston University School of Medicine, Section of Preventive Medicine and Epidemiology Boston, MA
5National Center for Health Statistics Hyattsville, MD

A relationship between cholesterol gallstone disease and atherosclerosis or its sequellae has long been postulated but has never been adequately proven. Data for this investigation of the relationship of diagnosed cholesterol cholelithiasis to subsequent incident coronary heart disease were obtained from a review of the pre-existing prospectively collected medical record of the 5,209 individuals followed since 1952 as members of the original cohort of the Framingham Heart Study. Preliminary univariate examination of these data, making no correction for time ordering of the conditions or for shared risk factors, indicated a significant modest positive association in men but no relationship in women. Logistic multiple regression analyses, allowing for the effects of time ordering and for eight standard coronary disease risk factors, confirmed these findings. The authors speculate that the presence of cholesterol gallstones in male patients may be indicative of an unfavorable lipoprotein profile. These results have clinical implications in that male gallstone patients are at increased risk for subsequent coronary disease and should be monitored accordingly. This investigation marks the first time that a relationship between these conditions has been established using a longitudinal cohort study approach.

arteriosclerosis; cholelithiasis; cholesterol; coronary disease


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