Title | The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The Cardiovascular Health Study. |
Publication Type | Journal Article |
Year of Publication | 2004 |
Authors | Psaty, BM, Anderson, M, Kronmal, RA, Tracy, RP, Orchard, T, Fried, LP, Lumley, T, Robbins, J, Burke, G, Newman, AB, Furberg, CD |
Journal | J Am Geriatr Soc |
Volume | 52 |
Issue | 10 |
Pagination | 1639-47 |
Date Published | 2004 Oct |
ISSN | 0002-8614 |
Keywords | African Americans, African Continental Ancestry Group, Aged, Female, Health Surveys, Humans, Incidence, Lipids, Male, Mortality, Myocardial Infarction, Population Surveillance, Prospective Studies, Risk Factors, Stroke, United States |
Abstract | <p><b>OBJECTIVES: </b>To assess the association between lipid levels and cardiovascular events in older adults.</p><p><b>DESIGN: </b>A prospective population-based study.</p><p><b>SETTING: </b>Four field centers in U.S. communities.</p><p><b>PARTICIPANTS: </b>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.</p><p><b>MEASUREMENTS: </b>Fasting lipid measures included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, and triglycerides.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSION: </b>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.</p> |
DOI | 10.1111/j.1532-5415.2004.52455.x |
Alternate Journal | J Am Geriatr Soc |
PubMed ID | 15450039 |
Grant List | AG09556 / AG / NIA NIH HHS / United States HL43201 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States RC-HL15103 / RC / CCR NIH HHS / United States RC-HL35129 / RC / CCR NIH HHS / United States |