The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The Cardiovascular Health Study.

Abstract

OBJECTIVES:

To assess the association between lipid levels and cardiovascular events in older adults.

DESIGN:

A prospective population-based study.

SETTING:

Four field centers in U.S. communities.

PARTICIPANTS:

A total of 5,201 adults aged 65 and older living in U.S. communities, plus a recruitment of 687 African Americans 3 years later.

MEASUREMENTS:

Fasting lipid measures included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, and triglycerides.

RESULTS:

At baseline, 1,954 men and 2,931 women were at risk for an incident myocardial infarction (MI) or stroke. During an average 7.5-year follow-up, 436 subjects had a coronary event, 332 had an ischemic stroke, 104 a hemorrhagic stroke, and 1,096 died. After adjustment, lipid measures were not major predictors of the outcomes of MI, ischemic stroke, hemorrhagic stroke, and total mortality. For total cholesterol and LDL-C, the associations with MI and ischemic stroke were only marginally significant. HDL-C was inversely associated with MI risk (hazard ratio=0.85 per standard deviation of 15.7 mg/dL, 95% confidence interval=0.76-0.96). For the outcome of ischemic stroke, high levels of HDL-C were associated with a decreased risk in men but not women. Lipid measures were generally only weakly associated with the risks of hemorrhagic stroke or total mortality.

CONCLUSION:

In this population-based study of older adults, most lipid measures were weakly associated with cardiovascular events. The association between low HDL-C and increased MI risk was nonetheless strong and consistent.

• Authors: Bruce M Psaty, Melissa Anderson, Richard A Kronmal, Russell P Tracy, Trevor Orchard, Linda P Fried, Thomas Lumley, John Robbins, Greg Burke, Anne B Newman, Curt D Furberg
• Journal: Journal of the American Geriatrics Society (J Am Geriatr Soc) Vol. 52 Issue 10 Pg. 1639-47 (Oct 2004) ISSN: 0002-8614 [Print] United States
• PMID: 15450039 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Lipids

Topics

• Black or African American
• Aged
• Black People
• Female
• Health Surveys
• Humans
• Incidence
• Lipids (blood)
• Male
• Mortality
• Myocardial Infarction (epidemiology, etiology)
• Population Surveillance (methods)
• Prospective Studies
• Risk Factors
• Stroke (epidemiology, etiology)
• United States (epidemiology)