Low-Density Lipoprotein Cholesterol and Mortality in Older People

doi:10.1111/j.1532-5415.2005.00492.x

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Wiley InterScience

Journal of the American Geriatrics Society

Volume 53 Issue 12, Pages 2159 - 2164

Published Online: 6 Oct 2005

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.

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Low-Density Lipoprotein Cholesterol and Mortality in Older People

Valérie Tikhonoff, MD ^* , Edoardo Casiglia, MD ^* , Alberto Mazza, MD, PhD ^* , Roberta Scarpa, MD ^* , Lutgarde Thijs, MSc ^† , Achille C. Pessina, MD, PhD ^* and Jan A. Staessen, MD, PhD. ^†

From the ^*Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy; and ^†Study Coordinating Center, Hypertension and Cardiovascular Rehabilitation Unit, Department of Molecular and Cardiovascular Research, University of Leuven, Leuven, Belgium

Address correspondence to Dr. Edoardo Casiglia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Padova, Via Giustiniani 2, I-35128 Padova, Italy. E-mail: edoardo.casiglia@unipd.it

KEYWORDS

elderly • mortality • ischemic heart disease • cardiovascular risk factors

ABSTRACT

Objectives: To investigate the role of low-density lipoprotein cholesterol (LDL-C) as a predictor of mortality in elderly subjects.

Design: Population-based prospective cohort study.

Setting: Two communities in northern Italy.

Participants: Three thousand one hundred twenty Caucasian subjects aged 65 and older recruited in for the Cardiovascular Study in the Elderly and followed up for 12 years.

Measurements: Anthropometric measures: fasting plasma total cholesterol, triglyceride, high-density lipoprotein cholesterol, LDL-C, glucose, creatinine, and body mass index. Clinical measures: medical assessment, diabetes mellitus, hypertension, stroke, coronary disease, heart failure, and smoking and drinking habits. Vital status measures: death certificates from the Registry Office and causes of death according to the International Classification of Diseases. After plotting mortality rates using quartiles of LDL-C, relative hazard rates (RHRs) were calculated using multivariate Cox regression analyses. When the trend was nonlinear, the RHRs were further calculated for the 25th, 50th, and 75th percentiles of the distribution to confirm curvilinearity.

Results: The distribution of risk of total mortality in women and of fatal heart failure in all subjects was curvilinear (non J-shaped), decreasing nonlinearly with LDL-C. For total mortality in men and cardiovascular mortality in both sexes, the relationship with LDL-C was J-shaped. The risk of fatal myocardial infarction was J-shaped in men, whereas it increased linearly with higher LDL-C in women. In both sexes, the association between stroke mortality and LDL-C was not significant.

Conclusion: This study adds to the uncertainty of the role of elevated levels of LDL-C as a risk factor for mortality in old people.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1532-5415.2005.00492.x About DOI