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Prospective Association Between Low and High Total and Low‐Density Lipoprotein Cholesterol and Coronary Heart Disease in Elderly Men
Author(s) -
Curb J. David,
Abbott Robert D.,
Rodriguez Beatriz L.,
Masaki Kamal,
Popper Jordan,
Chen Randi,
Petrovitch Helen,
Blanchette Patricia,
Schatz Irwin,
Yano Katsuhiko
Publication year - 2004
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2004.52551.x
Subject(s) - medicine , subclinical infection , prospective cohort study , cholesterol , coronary heart disease , incidence (geometry) , population , risk factor , cardiology , gerontology , endocrinology , environmental health , physics , optics
Objectives: To examine the relationship between total cholesterol (TC) and low‐density lipoprotein cholesterol (LDL‐C) and the incidence of coronary heart disease (CHD) in elderly men. Design: Prospective. Setting: Population based. Participants: A sample of 2,424, Japanese‐American men aged 71 to 93 was used. Measurements: Six years of data on incident fatal plus nonfatal CHD were examined. Results: Analysis revealed a significant U‐shaped relationship between age‐adjusted CHD rates and both TC and LDL‐C. The ranges of TC and LDL‐C with the lowest risk of CHD were 200 to 219 mg/dL and 120 to 139 mg/dL, respectively. As cholesterol concentrations declined and increased beyond these ranges, the risk of CHD increased. These U‐shaped relationships remained significant after adjusting for age and other risk factors. Conclusion: The U‐shaped associations between TC and LDL‐C and CHD imply a complex relationship between lipids and CHD in late life. The results indicate that elevated lipid levels should continue to be treated in healthy elderly individuals, as they are in those who are younger, although pharmacologically lowering lipids to excessively low levels in the elderly may warrant further study, as does the contribution of subclinical frailty to the relationship of lipids to CHD risk.