Coronary risk profile of young soldiers with coronary heart disease.

In a retrospective study of coronary risk factors in young soldiers with coronary heart disease (CHD), designed to explain why junior ranks in the British Army have a higher mortality rate from CHD than comparable British civilians, high prevalence of heavy cigarette smoking was found to be the major discriminant. In general, young men with CHD have higher prevalence of cigarette smoking, and a higher per capita consumption than older men with CHD. They also have higher cholesterol levels, perhaps resulting from more symptomatic cases of familial hypercholesterolaemia in the younger age group. Young affected soldiers are more obese than young affected civilians and smoke more cigarettes (24% smoke 40 or more per day). This may be related to the reduced cost of cigarettes to soldiers in some parts of the world. In the British Army, the expected protective effect of physical fitness is overwhelmed by the deleterious effect of high cigarette consumption.