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Differing predictive relationships between baseline LDL-C, systolic blood pressure, and cardiovascular outcomes

Prakash C Deedwania1, Terje R Pedersen2, David A DeMicco3

  • 1UCSF School of Medicine, Cardiology Division, Fresno, CA, USA.

International Journal of Cardiology
|August 12, 2016
PubMed

Insights

High baseline systolic blood pressure (SBP) predicts stroke, while high low-density lipoprotein cholesterol (LDL-C) predicts coronary events in high-risk patients. These cardiovascular risk factors have differential impacts on vascular outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Epidemiology

Background:

  • Cardiovascular disease (CVD) risk is elevated in patients with diabetes.
  • Traditional risk factors like hypertension and dyslipidemia are key contributors to CVD.
  • Investigating predictive values of baseline systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) is crucial for high-risk populations.

Purpose of the Study:

  • To evaluate the predictive significance of baseline SBP and LDL-C for vascular outcomes.
  • To analyze the differential impact of SBP and LDL-C on coronary events versus stroke.
  • To assess these associations in a large cohort of patients at high risk for cardiovascular events, including a diabetic subgroup.

Main Methods:

  • Pooled data from three large clinical trials: TNT, CARDS, and IDEAL, totaling 21,727 patients.
  • Utilized multivariate Cox proportional-hazards models to assess the impact of baseline SBP and LDL-C.
  • Analyzed cardiovascular events, coronary events, and stroke as primary outcomes.

Main Results:

  • Higher baseline SBP and LDL-C were significantly associated with increased cardiovascular event risk overall.
  • Baseline SBP predicted stroke risk, whereas higher LDL-C predicted coronary event risk.
  • In the diabetic subgroup, baseline SBP did not predict coronary or stroke events, while LDL-C remained predictive of coronary events.

Conclusions:

  • Baseline SBP and LDL-C are significant predictors of cardiovascular outcomes in high-risk individuals.
  • The predictive value of these factors differs between cerebrovascular events (stroke) and coronary events.
  • Findings highlight the distinct roles of blood pressure and cholesterol in different vascular territories.
Abstract

Keywords:
Cardiovascular diseaseCardiovascular risk predictionDiabetesLow-density lipoprotein cholesterolStrokeSystolic blood pressure

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