Abstract
Although increased low-density lipoprotein cholesterol (LDL-C) is one of the major risk factors for the cardiovascular disease (CVD), the associations of LDL-C with CVD and all-cause mortality are unclear in elderly (≥75 years) individuals. A total of 3674 individuals aged 75 or older underwent medical examinations at the Kailuan Group from 2006 to 2007, including 3478 males (94.67%) and 196 females (5.33%). Participants were divided into three groups based on the LDL-C level: the ideal level (LDL-C < 100 mg/dl), appropriate level (100 mg/dl ≤ LDL-C < 130 mg/dl) and elevated level (LDL-C ≥ 130 mg/dl) groups. CVD and all-cause mortality events were recorded during the follow-up period. The Cox proportional hazards regression model was applied to evaluate the effects of LDL-C on CVD and all-cause mortality events. The average follow-up time was 9.87 ± 3.60 years. After adjustment for confounding factors, the multivariate Cox proportional hazards regression model showed that the CVD risk in the elevated level group was 1.45 (95% CI, 1.08-1.95), acute myocardial infarction risk was 1.96 (95% CI, 1.19-3.24) and all-cause mortality risk was 1.18 (95% CI, 1.02-1.37) compared with those in the ideal level group. For every standard deviation increase in LDL-C levels, the CVD risk increased by 10%, acute myocardial infarction risk increased by 21% and all-cause mortality event risk increased by 4%. No association was observed between elevated LDL-C levels and the risk of stroke. In the sample of older Chinese individuals investigated in the present study, elevated LDL-C levels (≥130 mg/dl) are a risk factor for CVD and all-cause mortality.
Highlights
Cardiovascular disease (CVD) is the leading cause of mortality in the global population,[1] animal experiments and clinical studies have confirmed that an increased low-density lipoprotein cholesterol (LDL-C) level is the main risk factor for the occurrence and development of atherosclerosis.[2,3] A number of randomized controlled trials using lipid-lowering drug interventions, such as a meta-analysis of 27 randomized controlled trials on the effectiveness and safety of reducing LDL-C treatments, have shown that lowering LDL-C levels can reduce the risk of cardiovascular disease (CVD) in the future
Elevated LDL-C mainly increased the risk of myocardial infarction, and no association was found between increased LDL-C and stroke risk
After adjusting for age, sex, smoking, drinking, physical exercise, education level, hypertension, diabetes, atrial fibrillation history, hs-CRP level, BMI, use of lipid-lowering drugs, and use of antihypertensive drugs, the results showed that the risk of CVD in the appropriate level group and the elevated group was 1.07 and 1.46, the risk of acute myocardial infarction was 1.00 and 2.08, and the risk of all-cause mortality was 1.12 and 1.17
Summary
Cardiovascular disease (CVD) is the leading cause of mortality in the global population,[1] animal experiments and clinical studies have confirmed that an increased low-density lipoprotein cholesterol (LDL-C) level is the main risk factor for the occurrence and development of atherosclerosis.[2,3] A number of randomized controlled trials using lipid-lowering drug interventions, such as a meta-analysis of 27 randomized controlled trials on the effectiveness and safety of reducing LDL-C treatments, have shown that lowering LDL-C levels can reduce the risk of CVD in the future. In randomized controlled trials on lipid-lowering therapy, none of the trials were conducted in elderly individuals ≥ 75 years of age. The associations of low-density lipoprotein cholesterol (LDL-C) with cardiovascular disease (CVD) and all-cause mortality are unclear in elderly(≥75 years) Chinese individuals
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