High-density vs low-density lipoprotein cholesterol as the risk factor for coronary artery disease and stroke in old age

Annelies W E Weverling-Rijnsburger; Iris J A M Jonkers; Eric van Exel; Jacobijn Gussekloo; Rudi G J Westendorp

doi:10.1001/archinte.163.13.1549

High-density vs low-density lipoprotein cholesterol as the risk factor for coronary artery disease and stroke in old age

Annelies W E Weverling-Rijnsburger
, Iris J A M Jonkers
, Eric van Exel
, Jacobijn Gussekloo
, Rudi G J Westendorp

Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands. [email protected]

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: A high total serum cholesterol level does not carry a risk of cardiovascular mortality among people 85 years and older and is related to decreased all-cause mortality. At this old age, there are few data on fractionated lipoprotein levels in the determination of cardiovascular disease risk. The aim of this study was to evaluate the relationships between low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels and mortality from specific causes among people in the oldest age categories.

METHODS: Between September 1, 1997, and September 1, 1999, a total of 705 inhabitants in the community of Leiden, the Netherlands, reached the age of 85 years. Among these old people, we initiated a prospective follow-up study to investigate determinants of successful aging. A total of 599 subjects participated (response rate, 87%) and all were followed up to September 2001. Serum levels of total, LDL, and HDL cholesterol were assessed at baseline along with detailed information on comorbid conditions. The main outcome measure was all-cause and specific mortality risk.

RESULTS: During 4 years of follow-up, 152 subjects died. The leading cause of death was cardiovascular disease, with similar mortality risks in all tertiles of LDL cholesterol level. In contrast, low HDL cholesterol level was associated with a 2.0-fold higher risk of fatal cardiovascular disease (95% confidence interval [CI], 1.2-3.2). The mortality risk of coronary artery disease was 2.0 (95% CI, 1.0-3.9) and for stroke it was 2.6 (95% CI, 1.0-6.6). Both low LDL cholesterol and low HDL cholesterol concentrations were associated with an increased mortality risk of infection: 2.7 (95% CI, 1.2-6.2) and 2.4 (95% CI, 1.1-5.6), respectively. The risks were unaffected by comorbidity.

CONCLUSION: In contrast to high LDL cholesterol level, low HDL cholesterol level is a risk factor for mortality from coronary artery disease and stroke in old age.

Original language	English
Pages (from-to)	1549-54
Number of pages	6
Journal	Archives of internal medicine
Volume	163
Issue number	13
DOIs	https://doi.org/10.1001/archinte.163.13.1549
Publication status	Published - 14 Jul 2003

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Aged
Aged, 80 and over
Cause of Death
Cholesterol, HDL/blood
Cholesterol, LDL/blood
Coronary Disease/blood
Female
Follow-Up Studies
Humans
Male
Netherlands/epidemiology
Proportional Hazards Models
Prospective Studies
Risk Factors
Stroke/blood

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10.1001/archinte.163.13.1549

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@article{65a8d096a9d841368b65e7a51418e665,

title = "High-density vs low-density lipoprotein cholesterol as the risk factor for coronary artery disease and stroke in old age",

abstract = "BACKGROUND: A high total serum cholesterol level does not carry a risk of cardiovascular mortality among people 85 years and older and is related to decreased all-cause mortality. At this old age, there are few data on fractionated lipoprotein levels in the determination of cardiovascular disease risk. The aim of this study was to evaluate the relationships between low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels and mortality from specific causes among people in the oldest age categories.METHODS: Between September 1, 1997, and September 1, 1999, a total of 705 inhabitants in the community of Leiden, the Netherlands, reached the age of 85 years. Among these old people, we initiated a prospective follow-up study to investigate determinants of successful aging. A total of 599 subjects participated (response rate, 87\%) and all were followed up to September 2001. Serum levels of total, LDL, and HDL cholesterol were assessed at baseline along with detailed information on comorbid conditions. The main outcome measure was all-cause and specific mortality risk.RESULTS: During 4 years of follow-up, 152 subjects died. The leading cause of death was cardiovascular disease, with similar mortality risks in all tertiles of LDL cholesterol level. In contrast, low HDL cholesterol level was associated with a 2.0-fold higher risk of fatal cardiovascular disease (95\% confidence interval [CI], 1.2-3.2). The mortality risk of coronary artery disease was 2.0 (95\% CI, 1.0-3.9) and for stroke it was 2.6 (95\% CI, 1.0-6.6). Both low LDL cholesterol and low HDL cholesterol concentrations were associated with an increased mortality risk of infection: 2.7 (95\% CI, 1.2-6.2) and 2.4 (95\% CI, 1.1-5.6), respectively. The risks were unaffected by comorbidity.CONCLUSION: In contrast to high LDL cholesterol level, low HDL cholesterol level is a risk factor for mortality from coronary artery disease and stroke in old age.",

keywords = "Aged, Aged, 80 and over, Cause of Death, Cholesterol, HDL/blood, Cholesterol, LDL/blood, Coronary Disease/blood, Female, Follow-Up Studies, Humans, Male, Netherlands/epidemiology, Proportional Hazards Models, Prospective Studies, Risk Factors, Stroke/blood",

author = "Weverling-Rijnsburger, \{Annelies W E\} and Jonkers, \{Iris J A M\} and \{van Exel\}, Eric and Jacobijn Gussekloo and Westendorp, \{Rudi G J\}",

year = "2003",

month = jul,

day = "14",

doi = "10.1001/archinte.163.13.1549",

language = "English",

volume = "163",

pages = "1549--54",

journal = "Archives of internal medicine",

issn = "0003-9926",

publisher = "American Medical Association",

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T1 - High-density vs low-density lipoprotein cholesterol as the risk factor for coronary artery disease and stroke in old age

AU - Weverling-Rijnsburger, Annelies W E

AU - Jonkers, Iris J A M

AU - van Exel, Eric

AU - Gussekloo, Jacobijn

AU - Westendorp, Rudi G J

PY - 2003/7/14

Y1 - 2003/7/14

N2 - BACKGROUND: A high total serum cholesterol level does not carry a risk of cardiovascular mortality among people 85 years and older and is related to decreased all-cause mortality. At this old age, there are few data on fractionated lipoprotein levels in the determination of cardiovascular disease risk. The aim of this study was to evaluate the relationships between low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels and mortality from specific causes among people in the oldest age categories.METHODS: Between September 1, 1997, and September 1, 1999, a total of 705 inhabitants in the community of Leiden, the Netherlands, reached the age of 85 years. Among these old people, we initiated a prospective follow-up study to investigate determinants of successful aging. A total of 599 subjects participated (response rate, 87%) and all were followed up to September 2001. Serum levels of total, LDL, and HDL cholesterol were assessed at baseline along with detailed information on comorbid conditions. The main outcome measure was all-cause and specific mortality risk.RESULTS: During 4 years of follow-up, 152 subjects died. The leading cause of death was cardiovascular disease, with similar mortality risks in all tertiles of LDL cholesterol level. In contrast, low HDL cholesterol level was associated with a 2.0-fold higher risk of fatal cardiovascular disease (95% confidence interval [CI], 1.2-3.2). The mortality risk of coronary artery disease was 2.0 (95% CI, 1.0-3.9) and for stroke it was 2.6 (95% CI, 1.0-6.6). Both low LDL cholesterol and low HDL cholesterol concentrations were associated with an increased mortality risk of infection: 2.7 (95% CI, 1.2-6.2) and 2.4 (95% CI, 1.1-5.6), respectively. The risks were unaffected by comorbidity.CONCLUSION: In contrast to high LDL cholesterol level, low HDL cholesterol level is a risk factor for mortality from coronary artery disease and stroke in old age.

AB - BACKGROUND: A high total serum cholesterol level does not carry a risk of cardiovascular mortality among people 85 years and older and is related to decreased all-cause mortality. At this old age, there are few data on fractionated lipoprotein levels in the determination of cardiovascular disease risk. The aim of this study was to evaluate the relationships between low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels and mortality from specific causes among people in the oldest age categories.METHODS: Between September 1, 1997, and September 1, 1999, a total of 705 inhabitants in the community of Leiden, the Netherlands, reached the age of 85 years. Among these old people, we initiated a prospective follow-up study to investigate determinants of successful aging. A total of 599 subjects participated (response rate, 87%) and all were followed up to September 2001. Serum levels of total, LDL, and HDL cholesterol were assessed at baseline along with detailed information on comorbid conditions. The main outcome measure was all-cause and specific mortality risk.RESULTS: During 4 years of follow-up, 152 subjects died. The leading cause of death was cardiovascular disease, with similar mortality risks in all tertiles of LDL cholesterol level. In contrast, low HDL cholesterol level was associated with a 2.0-fold higher risk of fatal cardiovascular disease (95% confidence interval [CI], 1.2-3.2). The mortality risk of coronary artery disease was 2.0 (95% CI, 1.0-3.9) and for stroke it was 2.6 (95% CI, 1.0-6.6). Both low LDL cholesterol and low HDL cholesterol concentrations were associated with an increased mortality risk of infection: 2.7 (95% CI, 1.2-6.2) and 2.4 (95% CI, 1.1-5.6), respectively. The risks were unaffected by comorbidity.CONCLUSION: In contrast to high LDL cholesterol level, low HDL cholesterol level is a risk factor for mortality from coronary artery disease and stroke in old age.

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KW - Aged, 80 and over

KW - Cause of Death

KW - Cholesterol, HDL/blood

KW - Cholesterol, LDL/blood

KW - Coronary Disease/blood

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Netherlands/epidemiology

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Risk Factors

KW - Stroke/blood

U2 - 10.1001/archinte.163.13.1549

DO - 10.1001/archinte.163.13.1549

M3 - Article

SN - 0003-9926

VL - 163

SP - 1549

EP - 1554

JO - Archives of internal medicine

JF - Archives of internal medicine

IS - 13

ER -

High-density vs low-density lipoprotein cholesterol as the risk factor for coronary artery disease and stroke in old age

Abstract

UN SDGs

Keywords

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