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Editor's Correspondence
December 13, 2004

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

Arch Intern Med. 2004;164(22):2500-2509. doi:10.1001/archinte.164.22.2506-b

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).