Editor's Correspondence |

Physiological Mechanisms for the Seasonal Changes in Serum Cholesterol Level—Reply

Ira S. Ockene, MD; David E. Chiriboga, MD, MPH; Edward J. Stanek III, PhD; Morton G. Harmatz, PhD; Robert Nicolosi, PhD; Gordon Saperia, MD; Arnold D. Well, PhD; Patty Freedson, PhD; Philip A. Merriam, MSPH; George Reed, PhD; Yungsheng Ma, PhD, MPH; Charles E. Matthews, PhD; James R. Hebert, ScD
Arch Intern Med. 2004;164(22):2500-2509. doi:10.1001/archinte.164.22.2506-b.
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In reply

We appreciate the comments of Manfredini and Boari and Donahoo and Eckel. Regarding the letter of Manfredini and Boari, we consider high cholesterol level to be a chronic risk factor for the development of coronary heart disease. However, the epidemiological observation of increased mortality from coronary heart disease in the winter could be related to a “clustering of peak values of haemostatic coronary risk factors,”1 which in turn might be linked to winter hemoconcentration. We are currently analyzing data from a substudy within the SEASON study data set,2 further exploring seasonal variation in fibrinogen levels and its relationship to changes in plasma volume (PV).

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