The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The cardiovascular health study

Bruce M. Psaty, Melissa Anderson, Richard A. Kronmal, Russell P. Tracy, Trevor Orchard, Linda P. Fried, Thomas Lumley, John A Robbins, Greg Burke, Anne B. Newman, Curt D. Furberg

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

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 15.7mg/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.

Original languageEnglish (US)
Pages (from-to)1639-1647
Number of pages9
JournalJournal of the American Geriatrics Society
Volume52
Issue number10
DOIs
StatePublished - Oct 2004

Fingerprint

Stroke
Myocardial Infarction
Lipids
Mortality
Health
HDL Cholesterol
LDL Cholesterol
Cholesterol
Social Adjustment
African Americans
Population
Fasting
Triglycerides
Odds Ratio
Confidence Intervals

Keywords

  • Cholesterol
  • Lipids
  • Myocardial infarction
  • Older adults
  • Stroke
  • Total mortality

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality : The cardiovascular health study. / Psaty, Bruce M.; Anderson, Melissa; Kronmal, Richard A.; Tracy, Russell P.; Orchard, Trevor; Fried, Linda P.; Lumley, Thomas; Robbins, John A; Burke, Greg; Newman, Anne B.; Furberg, Curt D.

In: Journal of the American Geriatrics Society, Vol. 52, No. 10, 10.2004, p. 1639-1647.

Research output: Contribution to journalArticle

Psaty, Bruce M. ; Anderson, Melissa ; Kronmal, Richard A. ; Tracy, Russell P. ; Orchard, Trevor ; Fried, Linda P. ; Lumley, Thomas ; Robbins, John A ; Burke, Greg ; Newman, Anne B. ; Furberg, Curt D. / The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality : The cardiovascular health study. In: Journal of the American Geriatrics Society. 2004 ; Vol. 52, No. 10. pp. 1639-1647.
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AU - Psaty, Bruce M.

AU - Anderson, Melissa

AU - Kronmal, Richard A.

AU - Tracy, Russell P.

AU - Orchard, Trevor

AU - Fried, Linda P.

AU - Lumley, Thomas

AU - Robbins, John A

AU - Burke, Greg

AU - Newman, Anne B.

AU - Furberg, Curt D.

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N2 - 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 15.7mg/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.

AB - 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 15.7mg/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.

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KW - Myocardial infarction

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KW - Stroke

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