Dyslipidemia is a major determinant of systemic atherosclerosis in the elderly: An autopsy study

Abstract

Background: Assessment of the pathobiological determinants of atherosclerosis is crucial for a better understanding of cardiovascular events.Methods: The study was conducted in 178 autopsy cases of in‐hospital death (104 men and 74 women; mean age, 81 years), for whom serum lipid values recorded during outpatient follow ups for chronic diseases were available. Severity of the atherosclerosis was semiquantitatively assessed in 10 arteries, and the correlations with age, sex, serum levels of total cholesterol and high‐density lipoprotein cholesterol (HDL‐C), and the history of hypertension, diabetes mellitus and/or smoking were evaluated.Results: The statistically significant risk factors differed between the genders and among the arterial systems. The effect of total cholesterol and HDL‐C was more prominent in women than in men. The odds ratio of an elevated total cholesterol value (per 0.1 g/L) for coronary atherosclerosis was 1.56 (95% confidence interval, 1.25–1.95, P < 0.001) in women and 1.19 (1.07–1.33, P = 0.002) in men. Hypertension, but not serum lipid profiles, was significantly associated with cerebral atherosclerosis in both genders (P < 0.05). Diabetes mellitus and smoking were associated with atherosclerosis in selected arteries.Conclusion: Dyslipidemia is a major determinant of atherosclerosis in the elderly, and control of dyslipidemia is still necessary in the elderly population.