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Non-high-density lipoprotein cholesterol level as a predictor of cardiovascular disease mortality
Y Cui1, R S Blumenthal, J A Flaws
1Director, Ciccarone Heart Center, The Johns Hopkins University, 600 W Wolfe St, Carnegie 538, Baltimore, MD 21287, USA. rblument@jhmi.edu
Insights
Non-high-density lipoprotein cholesterol (non-HDL-C) is a better predictor of cardiovascular disease (CVD) mortality than low-density lipoprotein cholesterol (LDL-C). Screening for non-HDL-C can improve CVD risk assessment.
Area of Science:
- Cardiovascular Medicine
- Lipidology
- Preventive Cardiology
Background:
- Non-high-density lipoprotein cholesterol (non-HDL-C) encompasses all atherogenic lipid particles.
- non-HDL-C may be a valuable predictor of cardiovascular disease (CVD) risk, similar to low-density lipoprotein cholesterol (LDL-C).
Purpose of the Study:
- To evaluate the utility of non-HDL-C levels in predicting CVD mortality.
- To compare the predictive performance of non-HDL-C versus LDL-C for CVD mortality.
Main Methods:
- Utilized data from the Lipid Research Clinics Program Follow-up Study (1972-1995).
- Observed 4462 men and women (aged 40-64) for an average of 19 years.
- Assessed cardiovascular disease (CVD) death as the primary outcome measure.
Main Results:
- Non-HDL-C and high-density lipoprotein cholesterol (HDL-C) were significant predictors of CVD death in both sexes.
- LDL-C was a weaker predictor of CVD death compared to non-HDL-C.
- A 0.78 mmol/L increase in non-HDL-C correlated with a 19% CVD risk increase in men and 11% in women, versus 15% and 8% for LDL-C.
Conclusions:
- Non-HDL-C demonstrates superior predictive value for CVD mortality compared to LDL-C.
- Routine screening of non-HDL-C levels can enhance cardiovascular disease risk assessment strategies.
Background:
Non-high-density lipoprotein cholesterol (non-HDL-C) contains all known and potential atherogenic lipid particles. Therefore, non-HDL-C level may be as good a potential predictor of risk for cardiovascular disease (CVD) as low-density lipoprotein cholesterol (LDL-C).
Objectives:
To determine whether non-HDL-C level could be useful in predicting CVD mortality and to compare the predictive value of non-HDL-C and LDL-C levels.
Methods:
Data are from the Lipid Research Clinics Program Follow-up Study, a mortality study with baseline data gathered from 1972 through 1976, and mortality ascertained through 1995. A total of 2406 men and 2056 women aged 40 to 64 years at entry were observed for an average of 19 years, with CVD death as the main outcome measure.
Results:
A total of 234 CVD deaths in men and 113 CVD deaths in women occurred during follow-up. Levels of HDL-C and non-HDL-C at baseline were significant and strong predictors of CVD death in both sexes. In contrast, LDL-C level was a somewhat weaker predictor of CVD death in both. Differences of 0.78 mmol/L (30 mg/dL) in non-HDL-C and LDL-C levels corresponded to increases in CVD risk of 19% and 15%, respectively, in men. In women, differences of 0.78 mmol/L (30 mg/dL) in non-HDL-C and LDL-C levels corresponded to increases in CVD risk of 11% and 8%, respectively.
Conclusions:
Non-HDL-C level is a somewhat better predictor of CVD mortality than LDL-C level. Screening for non-HDL-C level may be useful for CVD risk assessment.
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