TY - JOUR T1 - The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The Cardiovascular Health Study. JF - J Am Geriatr Soc Y1 - 2004 A1 - Psaty, Bruce M A1 - Anderson, Melissa A1 - Kronmal, Richard A A1 - Tracy, Russell P A1 - Orchard, Trevor A1 - Fried, Linda P A1 - Lumley, Thomas A1 - Robbins, John A1 - Burke, Greg A1 - Newman, Anne B A1 - Furberg, Curt D KW - African Americans KW - African Continental Ancestry Group KW - Aged KW - Female KW - Health Surveys KW - Humans KW - Incidence KW - Lipids KW - Male KW - Mortality KW - Myocardial Infarction KW - Population Surveillance KW - Prospective Studies KW - Risk Factors KW - Stroke KW - United States AB -

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.

VL - 52 IS - 10 U1 - https://www.ncbi.nlm.nih.gov/pubmed/15450039?dopt=Abstract ER -