Related Experiment Videos
HDL cholesterol predicts coronary heart disease mortality in older persons
M C Corti1, J M Guralnik, M E Salive
1Epidemiology, Demography and Biometry Program, National Institute on Aging/NIH, Bethesda, MD 20892, USA.
Insights
Low high-density lipoprotein cholesterol (HDL-C) significantly increases the risk of coronary heart disease (CHD) death and new events in individuals over 70. Elevated total cholesterol poses a risk for older women but not older men.
Area of Science:
- Cardiology
- Gerontology
- Epidemiology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality, particularly in older populations.
- Understanding lipid profiles, including total cholesterol and high-density lipoprotein cholesterol (HDL-C), is crucial for assessing CHD risk in the elderly.
Purpose of the Study:
- To investigate the association between total cholesterol and HDL-C levels with CHD mortality and the incidence of new CHD events in individuals aged 71 and older.
Main Methods:
- A prospective cohort study was conducted with a median follow-up of 4.4 years.
- Participants included 2527 women and 1377 men aged 71+ who underwent lipid measurements.
- Coronary heart disease mortality and new CHD events (fatal or hospitalization) were the primary outcome measures.
Main Results:
- Low HDL-C (<0.90 mmol/L) was associated with a 2.5-fold increased risk of CHD death, irrespective of age group or sex.
- Low HDL-C also predicted an increased risk of new CHD events (Relative Risk [RR], 1.4).
- Elevated total cholesterol showed a significant association with CHD mortality in women (RR, 1.8) but not in men (RR, 1.0). A 1-unit increase in the total cholesterol/HDL-C ratio correlated with a 17% increase in CHD death risk.
Conclusions:
- Low HDL-C is a significant predictor of both CHD mortality and the occurrence of new CHD events in individuals over 70 years of age.
- While elevated total cholesterol may be a risk factor for CHD in older women, it was not significantly associated with CHD mortality in older men.
Objectives:
To examine the relationship of total cholesterol and high-density lipoprotein cholesterol (HDL-C) with coronary heart disease (CHD) mortality and with occurrence of new CHD events in persons aged 71 years and older.
Design:
Prospective cohort study with a median of 4.4 years of follow-up.
Setting:
East Boston, Mass; New Haven, Conn; and Iowa and Washington counties, Iowa.
Participants:
A total of 2527 women and 1377 men who completed an interview, had serum lipid determinations, and survived at least 1 year. New CHD events were evaluated in persons with no CHD history or hospitalization.
Main Outcome Measures:
Death due to CHD (ICD-9 codes 410 through 414 as underlying cause of death); new occurrence of CHD events (fatal CHD or hospitalization with CHD [ICD-9 codes 410 through 414]).
Results:
After adjustment for established CHD risk factors, the relative risk (RR) of death due to CHD for those with low HDL-C (< 0.90 mmol/L [< 35 mg/dL]) compared with the reference group (HDL-C > or = 1.55 mmol/L [> or = 60 mg/dL]) was 2.5 (95% confidence interval [CI], 1.6 to 4.0). Elevated risk was present in subgroups aged 71 through 80 years (RR, 4.1; 95% CI, 1.9 to 8.8) and over 80 years (RR, 1.8; 95% CI, 0.99 to 3.4), and in men and women. Low HDL-C predicted an increased risk of occurrence of new CHD events (RR, 1.4; 95% CI, 1.1 to 2.0), with similar but nonsignificant results in subgroups of men and women. Total cholesterol was less consistently associated with CHD mortality than HDL-C. When we compared individuals with total cholesterol of at least 6.20 mmol/L (240 mg/dL) with the reference group with total cholesterol of 4.16 to 5.19 mmol/L (161 to 199 mg/dL), a significant risk of CHD mortality was seen for women (RR 1.8; 95% CI, 1.03 to 3.0) but not for men (RR, 1.0; 95% CI, 0.5 to 2.0). In the total population, for each 1-unit increase in the total cholesterol/HDL-C ratio there was a 17% increase in the risk of CHD death that was statistically significant.
Conclusions:
Low HDL-C predicts CHD mortality and occurrence of new CHD events in persons older than 70 years. Elevated total cholesterol was not found to be associated with CHD mortality in older men, but may be a risk factor for CHD in older women.