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

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.

%B J Am Geriatr Soc %V 52 %P 1639-47 %8 2004 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/15450039?dopt=Abstract %R 10.1111/j.1532-5415.2004.52455.x