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PubMed1991

Mortality in patients with substance abuse: a follow-up in Stockholm County, 1973-1984.

A group of patients (N = 1630) hospitalized in Stockholm County with a diagnosis of substance abuse during 1971-1972 were followed through 1984 as regards mortality: 446 (296 males and 150 females) patients died. The excess mortality in the cohort was 5.3 (males 5.8, females 4.6) compared to the general population in Stockholm County. The highest mortality was found in opiate users, with an excess mortality of 18.3. Fifty-one percent of the causes of death belonged to ICD-8 chapter 17, injury and poisoning, and of these, 69% (155 patients) were definite or probable suicides. Since HIV entered the Stockholm drug addict population by the end of this follow-up, the excess mortality reported here can be even higher in the years to come. To follow and monitor the mortality among patients with substance abuse is an important aspect in the evaluation of programs for prevention and treatment.

Adolescent↗
PubMed1991

Long-term prognosis after partial gastrectomy for benign conditions. Survival and smoking-related death of 2633 Amsterdam postgastrectomy patients followed up since surgery between 1931 and 1960.

Decreased life expectancy may occur after remote peptic ulcer surgery, but the cause of shortened survival is unclear. A 50-year follow-up study of an Amsterdam cohort of postgastrectomy patients who underwent ulcer surgery between 1931 and 1960 showed a statistically significant decrease in survival after a postoperative interval of 12 years or more compared with the general population. The shortened life expectancy mainly reflected decreased survival in men. In women, no significant difference in survival compared with the general population was observed. The excess mortality in men was predominantly due to a statistically significant increase in cancer-related deaths. Carcinoma of the lung accounted for the majority of excess mortality. No time relationship between lung cancer death and interval since surgery was observed. Thus, smoking, primarily in men who had undergone surgery for gastric ulcers, seems an important factor contributing to excess mortality and shortened life expectancy. Excess mortality due to tobacco use has also been observed in postmarketing surveillance of H2-receptor antagonists. Therefore, smoking cessation may provide the greatest improvement in the long-term prognosis of peptic ulcer patients, regardless of the treatment.

Adult↗
PubMed2003

Service screening with mammography of women aged 70-74 years in Sweden. Effects on breast cancer mortality.

Since the benefit of mammography screening for women 70 years and older is unclear, the aim of the present study was to evaluate the effect on breast cancer mortality of the population-based service-screening program in Sweden inviting women 70-74 years. Among the counties with service-screening programs in Sweden which started 1986-1990 those with upper age limit 74 years were compared to counties with 69 years as upper age limit with respect to refined breast cancer mortality. Allowance was made for potential biases namely inclusion of cases diagnosed before invitation and lead time. Two methods for estimation of breast cancer mortality were used; underlying cause of death (UCD) and excess mortality. With a mean follow-up of 10.1 years a reduction of the breast cancer excess mortality was estimated at 24%. Using the underlying cause of death the corresponding result was 6%. A non-significant reduction in breast cancer mortality was found in the counties with service-screening program including the age group 70-74 years in Sweden. The estimated reduction was larger when using excess mortality compared to the use of individual underlying cause of death.

Age Factors↗
PubMed1999

Deprivation and excess winter mortality.

OBJECTIVE: To investigate the effect of material deprivation on the winter rise in mortality and temperature dependent variations in mortality. DESIGN: Ecological comparison of seasonal mortality at electoral ward level. Main outcome measures were ratios of winter to rest of the year mortality rates (seasonality ratios) and monthly deaths as the outcome variable in a model with monthly average temperature and Townsend score as main predictors. SETTING: Croydon, London, United Kingdom. SUBJECTS: All deaths of Croydon residents for the period 1990-1995. MAIN RESULTS: There was a clear relation between overall mortality and deprivation. There was no evidence of a relation between age and sex standardised seasonality ratios and Townsend scores for all deaths (Kendall's tau = -0.066, p = 0.63) or cardiovascular deaths or respiratory deaths. There was no evidence of an interaction between Townsend score and temperature in the model of ward mortality rates (p = 0.73). These findings were not affected by exclusion of deaths of nursing and residential home residents. CONCLUSION: This study provides no evidence of an effect of deprivation on excess winter mortality or temperature dependent variations in mortality. The findings question simple assumptions about the relation between deprivation and excess winter mortality and highlight the need for further study to guide interventions.

Cold Temperature↗
PubMed1986

Birthweight and perinatal mortality: III. Towards a new method of analysis.

Perinatal mortality is closely related to birthweight. We propose a model that summarizes this relationship and provides a basis for the analysis of perinatal mortality. The components of this model are the frequency distribution of birthweight and the curve of weight-specific mortality. Taken together, these two curves completely describe perinatal mortality for a given population. The perinatal mortality of two populations can be meaningfully compared by plotting each weight-specific mortality curve relative to its own birthweight distribution. By this means, the excess mortality in one population can usually be expressed as the sum of two excess mortalities--one that occurs uniformly over the whole birthweight distribution, the other due to an increased number of small births. To illustrate this method, we analyse differences between white and black infants. We find that the excess mortality of black infants is chiefly due to an excess of small black births, but also to higher mortality over all (adjusted) birthweights. In contrast to other methods of analysis, the proposed method does not assume a priori that a difference in the mean birthweight of two populations is the cause of any difference in perinatal mortality. Furthermore, the proposed method is unbiased; in particular, it is preferable to direct or indirect standardization for birthweight, previously shown to be biased.

Birth Weight↗
PubMed2004

A mortality cohort study among workers in a graphite electrode production plant in Italy.

BACKGROUND: Graphite electrode manufacturing workers are exposed to coal tar and its volatiles containing a variety of polycyclic aromatic hydrocarbons (PAH), silica and graphite dusts, and asbestos. AIMS: To investigate mortality from cancer and other diseases among workers in a graphite electrode production plant in Italy. METHODS: A total of 1291 males actively employed between 1 January 1950 and 31 December 1989 who had worked at the plant for at least one year were studied. The follow up extended from 1950 to 1997. Standardised mortality ratios (SMR) and their 95% confidence intervals (CI) were computed using mortality rates for the Italian and regional male population. RESULTS: Excess mortality was observed for all causes (SMR 1.44, CI 1.32 to 1.56), all cancers (SMR 1.27, CI 1.07 to 1.50), liver cancer (SMR 4.19, CI 2.68 to 6.23), silicosis (SMR 66.39, CI 52.56 to 82.7), and cirrhosis and other chronic diseases of the liver (SMR 1.87, CI 1.31 to 2.59) in comparison with the national male population. When regional rates were used to calculate the number of expected deaths, SMRs remained higher for silicosis (SMR 57.32, 42.11 to 76.22), and liver cancer (SMR 2.57, 1.57 to 3.97). Mortality from silicosis was increased in workers hired at young ages (<25 years, SMR 81.79; 25-34 years, SMR 82.73), and in workers aged <45 at death (SMR 333.3, CI 159.8 to 613). Mortality from liver cancer increased threefold (SMR 3.11, CI 1.78 to 5.05) in workers with more than 10 years of employment at the plant during the manufacture of Karbate products. CONCLUSIONS: Results support the association between excess mortality from silicosis and occupational exposure to siliceous sands experienced during graphite electrode manufacturing. The observed excess mortality from liver cancer is compatible, to some extent, with exposures that may have occurred during the manufacture of phenolic and furfuryl resins treated products, although a role of lifestyle factors and viral infections cannot be excluded.

Adult↗
PubMed2001

Mortality in various types of osteogenesis imperfecta.

BACKGROUND: Osteogenesis imperfecta (OI) is a group of closely related inherited diseases characterized by abnormal bone fragility. The current clinical classification system delineates 6 types, one of which (type II) is so severe that mortality is 100%, either intrauterine or perinatal. The types are differentiated by clinical groups, by severity, and by the presence or absence of other features such as blue sclerae or dentinogenesis imperfecta. There are no known previous studies of mortality in OI. RESULTS: From a registry created in association with the Brittle Bone Society, 743 patients with OI in England and Wales were observed in the period 1980-1993. These were classified into 3 groups (type IA, type III, and types IB, IVA, and IVB combined). Average annual mortality rates were determined in each group by sex and attained age. These rates were compared with 1981 rates in the population of England and Wales, matched by sex and age. Results are given in terms of exposures, observed and expected deaths, and 2 indices of excess mortality: mortality ratios and excess death rates per 1000 person-years. CONCLUSION: In type IA, 51.5% of the OI cases overall, there was no significant excess mortality (mortality ratio 108%, based on 15 deaths). In type III, on the other hand, excess mortality was very high in children and still significantly high at ages 15-34 years. In the combined group of types IB, IVA, and IVB, the mortality ratio was 157% in patients aged 45 and up (not significant at the 95% confidence level), but higher ratios at younger ages were significant, even though based on a total of only 5 deaths.

Adult↗
PubMed1996

The potential for normal long term survival and morbidity rates after valve replacement for aortic stenosis.

BACKGROUND AND AIM OF THE STUDY: The sequelae of early aortic valve replacement (AVR) for aortic stenosis (AS) are controversial, with an increasing body of opinion regarding the patient risk profile as having an influence on long term survival and prosthesis-related morbidity rates. We therefore undertook a comparison of the morbidity and mortality rates of the patients undergoing AVR at our institution over a 22 year period with those in the background population to establish whether early intervention leads to an increased incidence of either. METHODS: A multivariate risk analysis of 630 consecutive patients with AS who were alive 30 days after AVR performed between January 1965 and December 1986 was completed. The patients had a mean age of 59 years (range 14-78 years), 98% received a mechanical prosthetic valve, and 71% were in functional classes III or IV preoperatively. RESULTS: Relative to an age- and sex-matched background population, the patients suffered a slight excess mortality during the first postoperative year, and a significant excess mortality after the 12th year, which was primarily related to congestive heart failure (64% of deaths versus 25% during the first 12 years; p < 0.01). A multivariate Cox regression model allowed calculation of a prognostic index for each patient. The index divided the patients into three groups (from low to high index): group A (n = 195) had normal sex- and age-specific survival, group B (n = 165) had a slight late (> 12th year) excess mortality, while group C (n = 270) had significant excess mortality throughout the follow up. Multivariate risk analysis of thromboembolism (1.7%/pt-yr), anticoagulant related hemorrhage (1.5%/pt-yr), all prosthesis-related complications combined (4.2%/pt-yr), and sudden cardiac events (arrhythmia and myocardial infarct; 1.8%/pt-yr) identified variables underlying advanced preoperative heart disease, coronary artery disease and systemic hypertension as the decisive risk factors. The preoperative prevalence of these risk factors as well as the postoperative incidence of the complications differed significantly between the three patient groups; A < B < C. Incidence rates of stroke in the patients (95% confidence interval) and in sex- and age-matched background populations were: group A, 0.48 (0.13-0.83) and 0.34 %/pt-yr, respectively, group B, 1.07 (0.46-1.68) and 0.52%pt-yr, respectively, and group C, 2.28 (1.50-3.06) and 0.68%/pt-yr respectively. Similar results were obtained for incidence rates of myocardial infarct. CONCLUSION: Operative intervention early in the course of AS, being equivalent to a favorable risk profile, may result in an age- and sex-specific normal long term survival, generally low rates of prosthesis-related complications and a normal incidence of the dominant thromboembolic and hemorrhagic events and of myocardial infarction.

Adolescent↗
PubMed2007

The relationship between generalized anxiety disorder, depression and mortality in old age.

BACKGROUND: The association between depression and an increased risk of death in elderly persons has been established in both clinical and community studies. Co-occurrence of depression and generalized anxiety has been shown to represent more severe and more chronic psychopathology. However, little is known about the relation between generalized anxiety disorder, mixed anxiety-depression (generalized anxiety disorder and depression) and excess mortality in the elderly. OBJECTIVE: To investigate whether generalized anxiety and mixed anxiety-depression are associated with mortality. METHOD: Generalized anxiety disorder, mixed anxiety-depression and depression were assessed in 4051 older persons with a ten-year follow-up of community death registers. The mortality risk of generalized anxiety, depression and mixed anxiety-depression was calculated after adjustment for demographic variables, physical illness, functional disabilities and social vulnerability. RESULTS: In generalized anxiety disorder and mixed anxiety-depression no significant excess mortality was found. In depression a significant excess mortality was found in men [HR 1.44 (1.09-1.89)] but not in women [HR 1.04 (0.87-1.24)] after adjustment for the different variables. CONCLUSIONS: In elderly persons depression increases the risk of death in men. Neither generalized anxiety nor mixed anxiety-depression are associated with excess mortality. Generalized anxiety disorder may even predict less mortality in depressive elderly people. The relation between generalized anxiety disorder and its possibly protective effect on mortality has to be further explored.

Aged↗
PubMed1986

Prognostic significance of signs and symptoms in hydrocephalus. Analysis of survival.

An analysis of survival, using Cox's regression model, was performed on 231 patients with hydrocephalus diagnosed before age five years. Age range at follow-up was 21-35 years. The only constant covariate of prognostic importance was asphyxia with a factor of excess mortality of 1.70. Important time-dependent covariates were: a head circumference increasingly above the 97th percentile and/or a radiological diagnosis of hydrocephalus, general seizures, a short lapse of time since diagnosis, and the sign of downward-displaced eyes. The excess mortality of patients with the sign of downward-displaced eyes could not be expressed by a factor of excess mortality, because this was age-dependent. For the other time dependent covariates the factors of excess mortality were 2.5-6.3. Complications during pregnancy and at birth, sex, birth weight, and surgical treatment of those days were not significant for survival. Examples of survival functions with different values for the time-dependent covariates are given.

Adolescent↗
PubMed1991

Cancer mortality in merchant seamen.

Cancer mortality excess has been reported repeatedly over the past hundred years to occur in merchant seamen. More recently lung cancer has been found to account for some of this excess and the question of the contribution made by cigarette smoking raised. In the one study where there was some information on smoking habit, it did not appear that cigarettes would have accounted for all the excess cancer observed. In other mortality studies, where excess cancer mortality was observed, the other cigarette-linked causes of death were not prominent. In a preliminary mortality analysis of a small population of merchant seamen, two cases of malignant mesothelioma have so far been identified, and in a national mesothelioma register 28 cases have been reported in seamen: both instances constitute abnormal occurrences. The presence of substantial amounts of asbestos-containing materials in naval construction which are continuously subjected to vibration and intermittently disturbed during servicing, and the detection of radiological stigmata consistent with asbestos exposure, add plausibility to the hypothesis that occupational asbestos exposure contributes to the apparent excess cancer mortality in merchant seamen. Methodologic deficiencies in epidemiologic studies reported to date make for uncertainty. Properly designed studies will be needed to quantify disease excess and to identify potentially causal associations. Even in the absence of such data it would be prudent to contain the asbestos currently installed and to promote smoking cessation programs.

Adolescent↗
PubMed1997

Occupational exposure to ionising radiation and mortality among workers of the former Spanish Nuclear Energy Board.

OBJECTIVES: Firstly, to ascertain whether mortality among workers of the former Spanish Nuclear Energy Board (Junta de Energía Nuclear-JEN) was higher than that for the Spanish population overall; and secondly, if this were so, to ascertain whether this difference was associated with exposure to ionising radiation. METHODS: A retrospective follow up of a cohort of 5657 workers was carried out for the period 1954-92. Cohort mortality was compared with that for the Spanish population overall, with standardised mortality ratios (SMRs) adjusted for sex, age, and calendar period. Also, Poisson models were used to analyse mortality from lung cancer in the cohort by level of exposure to ionising radiation. RESULTS: Workers' median and mean cumulative exposures were 4.04 and 11.42 mSv, respectively. Mean annual exposure was 1.33 mSv. Excess mortality due to bone tumours was found for the cohort as a whole (six deaths observed; SMR 2.95; 95% confidence interval (95% CI) 1.08 to 6.43). Among miners, excess mortality was found for non-malignant respiratory diseases (SMR 2.94; 95% CI 2.27 to 3.75), and for lung cancer bordering on statistical significance (SMR 1.50; 95% CI 0.96 to 2.23; P = 0.055). Relative risks of dying of lung cancer from ionising radiation in the dose quartiles 2, 3, and 4 versus the lowest dose quartile, were 1.00, 1.64, and 0.94, respectively. CONCLUSIONS: Excess mortality from lung cancer was found among JEN miners. Nevertheless, no clear relation was found between mortality from lung cancer and level of exposure to ionising radiation in the JEN cohort. Continued follow up of the cohort is required to confirm excess mortality from bone tumours.

Bone Neoplasms↗
PubMed2004

Worldwide variation in life-span sexual dimorphism and sex-specific environmental mortality rates.

In all human populations mean life span of women generally exceeds that of men, but the extent of this sexual dimorphism varies across different regions of the world. Our purpose here is to study, using global demographic and environmental data, the general tendency of this variation and local deviations from it. We used data on male and female life history traits and environmental conditions for 227 countries and autonomous territories; for each country or territory the life-span dimorphism was defined as the difference between mean life spans of women and men. The general tendency is an increase of life-span dimorphism with increasing average male-female life span; this tendency can be explained using a demographic model based on the Makeham-Gompertz equation. Roughly, the life-span dimorphism increases with the average life span because of an increase in the duration of expressing sex- and age-dependent mortality described by the second (exponential) term of the Makeham-Gompertz equation. Thus we investigated the differences in male and female environmental mortality described by the first term of the Makeham-Gompertz equation fitted to the data. The general pattern that resulted was an increase in male mortality at the highest and lowest latitudes. One plausible explanation is that specific factors tied to extreme latitudes influence males more strongly than females. In particular, alcohol consumption increases with increasing latitude and, on the contrary, infection pressures increase with decreasing latitude. This finding agrees with other observations, such as an increase in male mortality excess in Europe and Christian countries and an increase in female mortality excess in Asia and Muslim countries. An increase in the excess of female mortality may also be due to increased maternal mortality caused by an increase in fertility. However, this relation is not linear: In regions with the highest fertility (e.g., in Africa) the excess of female mortality is smaller than in regions with relatively lower fertility (e.g., in Asia). A possible explanation of this phenomenon is an evolutionary adaptation of women to the pressures of extremely high fertility by means of some reduction of their maternal mortality.

Age Factors↗
PubMed2001

Mortality following conjugal bereavement, Belgium 1991-96: the unexpected effect of education.

This paper examines excess mortality following spousal bereavement by time since bereavement, sex, age, and education. The main hypothesis challenged is that higher education buffers the harmful effects of spousal loss. Using a log-rate model, death-rate ratios (widowed/married) are estimated for 49,849 and 126,746 Belgian widowers and widows and an equal number of non-bereaved controls matched to the bereaved on their socio-demographic characteristics. The hypothesis that the more educated suffer less excess mortality is not supported. Although higher educational levels are associated with lower mortality in general, they do not alleviate the effects of bereavement. On the contrary, in the period immediately following spousal loss, the more highly educated seem to have more, rather than less, excess mortality. Three possible arguments are suggested to account for this: education-related differences in the partner-relationship, structural differences in the availability of appropriate social support, and cultural differences in potential support networks.

Belgium↗
PubMedDate not supplied

Survival after vagotomy: results of the Aarhus County Vagotomy Trial.

In order to investigate whether the previously found excess mortality in surgically-treated patients with peptic ulcer might be due partly to the resections employed, a survival analysis was undertaken in 824 patients 8-13 years after different types of vagotomy. These patients had been submitted to selective gastric vagotomy with drainage, selective gastric vagotomy with antrectomy or parietal cell vagotomy with or without drainage for duodenal ulcer, pyloric ulcer, prepyloric ulcer, or combined ulceration during the period from 1972 to 1977. A statistically significant excessive mortality was found for both sexes in the total material compared to the background population. Analysis of the material, subdivided according to the operative methods employed, revealed a significant excess mortality in men treated with selective gastric vagotomy and antrectomy, whereas the mortality rates were slightly and insignificantly raised in the nonantrectomy groups. No significant difference in the mortality could be demonstrated in relation to the site of the ulcers. Analysis of the cause-specific mortality revealed a significantly raised mortality from gastrointestinal diseases, including a significant excessive mortality in the subgroups of benign peptic ulcer and cirrhosis of the liver. Likewise, the death rate from accidents including the subgroup of suicide was significantly increased. The overall mortality from malignancies was insignificantly raised among patients, whereas cancer in the stomach was significantly increased. An increased mortality from cancer in the lungs and pancreas did not reach statistical significance. These findings are in reasonable accordance with other studies. A significantly increased mortality from gastric cancer has been usual, although not a constant finding after gastric resection.(ABSTRACT TRUNCATED AT 250 WORDS)

Denmark↗
PubMed2001

Mortality among epilepsy patients attending a tertiary referral center in a developing country.

Epilepsy is associated with excess mortality of two to three times in developed countries. Precise epidemiological data on mortality and cause of death are not available from India or most other developing countries. This study was carried out to estimate the mortality rates and to identify the demographic and clinical characteristics associated with mortality in a hospital based cohort of epilepsy patients. A cohort of patients enrolled in the epilepsy clinic in 1985 was followed up till 1997 (12 years). The mortality rate, demographic and clinical correlate of mortality were analysed for 246 patients (men 161, women 85) who had complete data. Cause of death was not examined in this study. Eighteen (men 15, women 3) of the 246 patients (7.3%) had died during the follow up period of 12 years. The crude death rate for the state of Kerala for the year 1990 (mid period of the study) was 5.9 per thousand population. The demographic and clinical characteristics of those who died (corresponding figures for survivors are given in brackets) were as follows: mean age 33.6 years (22.8 years), presence of abnormal neurological examination 38.9% (15.4%), mental retardation 33.3% (12.8%), abnormal CT scan 38% (21.5%). Regarding the seizure frequency at the time of enrollment and eventual mortality, there were no deaths among patients who had an Engel's seizure score of less than or equal to 4 (no seizures or nocturnal seizures only). The mortality was 5% for an Engel's score of 5 or 6 and 11% for an Engel's score greater than 6. Within the group with epilepsy, higher seizure frequency at the time of initial evaluation was associated with excess mortality. Abnormality on neurological examination, older age group and male sex were other factors that correlated with excess mortality.

Adolescent↗
PubMed2005

Ovarian conservation at the time of hysterectomy for benign disease.

OBJECTIVE: Prophylactic oophorectomy is often recommended concurrent with hysterectomy for benign disease. The optimal age for this recommendation in women at average risk for ovarian cancer has not been determined. METHODS: Using published age-specific data for absolute and relative risk, both with and without oophorectomy, for ovarian cancer, coronary heart disease, hip fracture, breast cancer, and stroke, a Markov decision analysis model was used to estimate the optimal strategy for maximizing survival for women at average risk of ovarian cancer. For each 5-year age group from 40 to 80 years, 4 strategies were compared: ovarian conservation or oophorectomy, and use of estrogen therapy or nonuse. Outcomes, as proportion of women alive at age 80 years, were measured. Sensitivity analyses were performed, varying both relative and absolute risk estimates across the range of reported values. RESULTS: Ovarian conservation until age 65 benefits long-term survival for women undergoing hysterectomy for benign disease. Women with oophorectomy before age 55 have 8.58% excess mortality by age 80, and those with oophorectomy before age 59 have 3.92% excess mortality. There is sustained, but decreasing, benefit until the age of 75, when excess mortality for oophorectomy is less than 1%. These results were unchanged following multiple sensitivity analyses and were most sensitive to the risk of coronary heart disease. CONCLUSION: Ovarian conservation until at least age 65 benefits long-term survival for women at average risk of ovarian cancer when undergoing hysterectomy for benign disease.

Adult↗
PubMed1991

Cholesterol screening and life assurance.

OBJECTIVES: To examine how insurance companies assess proposals for life assurance from applicants with raised cholesterol concentrations and to determine the excess mortality rating applied. DESIGN: Survey of 49 companies underwriting term life assurance. SETTING: United Kingdom. SUBJECTS: Four fictional men aged 30 seeking 20 year term policies paying benefit only on death. Two had total cholesterol concentrations of 6.4 and 8.1 mmol/l but no other cardiovascular risk factors; one was overweight, hypertensive, smoked 20 cigarettes daily, and had a total cholesterol concentration of 8.1 mmol/l; and one had possible familial hypercholesterolaemia and a total cholesterol concentration of 10.7 mmol/l after treatment. MAIN OUTCOME MEASURE: Percentage excess mortality rating. RESULTS: All companies used explicit criteria to assess the mortality risk associated with hyperlipidaemias, and 47 companies applied the same criteria to men and women. No excess mortality rating was imposed on an applicant with a total cholesterol concentration of 6.4 mmol/l, but a small excess was applied to an applicant with a concentration of 8.1 mmol/l (median excess 50%, range 0-75%). When multiple cardiovascular risk factors were present the same concentration of 8.1 mmol/l resulted in a substantial excess (median 135%, range 50-200%). A smaller but more variable excess was applied to an applicant with possible familial hypercholesterolaemia (median 75%, range 0-200%). CONCLUSIONS: Despite considerable differences among companies in the excess mortality ratings applied, increases in term life assurance premiums are likely to be restricted to patients with severe hypercholesterolaemia, in particular those with familial hypercholesterolaemia. In the absence of other cardiovascular risk factors milder hypercholesterolaemia is unlikely to result in higher premiums.

Adult↗