Lack of Association Between Cholesterol and Coronary Heart Disease Mortality and Morbidity and All-Cause Mortality in Persons Older Than 70 Years

Krumholz, Harlan M.; Seeman, Teresa E.; Merrill, Susan S.; Leon, Carlos F. Mendes de; Vaccarino, Viola; Silverman, David I.; Tsukahara, Reiko; Ostfeld, Adrian M.; Berkman, Lisa F.

doi:10.1001/jama.1994.03520170045034

Cited by 397 publications

(156 citation statements)

References 22 publications

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“…A similar pattern of the protective effects of cholesterol has also been found among adults older than 55, who evince an inverse relationship between total cholesterol and several infectious diseases (Iribarren et al 1998). Conversely, studies of younger adults reveal that the effect of total cholesterol on noncardiovascular mortality is neutral (Kronmal et al 1993;Krumholz et al 1994;Gould et al 1995). Another study finds a trend of increased noncardiovascular mortality with decreased LDL, in both placebo and treatment groups (Razzolini et al 2008).…”

Section: Cholesterol and Infectionsupporting

confidence: 54%

Boots for Achilles: Progesterone's Reduction of Cholesterol Is a Second-Order Adaptation

Amir¹,

Fessler²

2013

The Quarterly Review of Biology

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Section: Cholesterol and Infectionsupporting

confidence: 54%

Boots for Achilles: Progesterone's Reduction of Cholesterol Is a Second-Order Adaptation

Amir¹,

Fessler²

2013

The Quarterly Review of Biology

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“…Whereas low HDL-cholesterol is predictive of cardiovascular disease even among people >70 years old [29,30], observational studies in the elderly have either shown no predictive effect of plasma LDL-cholesterol or a protective effect of higher concentrations [3][4][5][6]. In a large population-based cohort of elderly people in the USA, 20% of whom had diabetes, the protective effect of higher concentrations of total choles- terol disappeared after adjustment for markers of poor health, suggesting confounding effects of comorbidity and frailty [5].…”

Section: Discussionmentioning

confidence: 99%

“…This association is weaker in older people, with an apparent paradoxical protective effect of high concentrations of cholesterol in some observational studies [2][3][4][5][6][7]. Measurement of plasma apolipoprotein (Apo) B and ApoA-I improves the prediction of cardiovascular disease, allowing identification of high-risk individuals who are not identified by the standard lipid profile [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Effect of age on the association of non-high-density-lipoprotein cholesterol and apolipoprotein B with cardiovascular mortality in a Mediterranean population with type 2 diabetes: the Casale Monferrato study

et al. 2006

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Aims/hypothesis: Measurement of plasma apolipoprotein (Apo) B may improve prediction of cardiovascular risk, as it provides a measure of the total number of atherogenic particles. The aim of this population-based study was to compare the association of non-HDLcholesterol, ApoB and the ApoB:ApoA-I ratio with cardiovascular mortality in people with type 2 diabetes. Subjects and methods: We assessed the association of lipids, lipoprotein lipids and apolipoproteins with 11-year mortality from cardiovascular disease in the populationbased cohort of the Casale Monferrato Study (1,565 people with diabetes; median age 68.9 years), and determined the effect of age (≤70 and >70 years) on these relationships. Results: On the basis of 341 deaths from cardiovascular disease in 10,809 person-years of observation, there was a decreasing trend in risk adjusted for multiple factors across quartiles of total cholesterol, and LDL-and non-HDL-cholesterol in people aged >70 years, but no trend in those aged ≤70 years. Age did not affect the protective effect of HDL-cholesterol. ApoB and ApoB:ApoA-I were associated with outcome in people in both age groups independently of non-HDLcholesterol. After adjustment for multiple factors, including non-HDL-cholesterol, the hazard ratios for ApoB: ApoA-I in the upper vs lower quartile were 2.98 (95% CI 1.15-7.75; p for trend=0.009) for people aged ≤70 years and 1.94 (95% CI 1.20-3.13; p for trend=0.003) for those aged >70 years. Conclusions/interpretation: In this cohort of Mediterranean subjects with diabetes, ApoB and the ApoB:ApoA-I ratio were associated with cardiovascular disease mortality independently of non-HDLcholesterol. Our findings support the recommendation that ApoB and ApoA-I should be measured routinely in all people with diabetes, particularly in the elderly.

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“…The role of RFs on cardiovascular morbidity and mortality may be influenced by age [10], gender [11], and by ethnic or geografic factors [12].…”

Section: Age and Gendermentioning

confidence: 99%

Association of coronary risk factors and behaviours in old age

Marchioli¹

2017

Interventional-Cardiology.

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Lack of Association Between Cholesterol and Coronary Heart Disease Mortality and Morbidity and All-Cause Mortality in Persons Older Than 70 Years

Abstract: Our findings do not support the hypothesis that hypercholesterolemia or low HDL-C are important risk factors for all-cause mortality, coronary heart disease mortality, or hospitalization for myocardial infarction or unstable angina in this cohort of persons older than 70 years.

Cited by 397 publications

References 22 publications

Boots for Achilles: Progesterone's Reduction of Cholesterol Is a Second-Order Adaptation

Boots for Achilles: Progesterone's Reduction of Cholesterol Is a Second-Order Adaptation

Effect of age on the association of non-high-density-lipoprotein cholesterol and apolipoprotein B with cardiovascular mortality in a Mediterranean population with type 2 diabetes: the Casale Monferrato study

Association of coronary risk factors and behaviours in old age

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