title: Serum lipids and incidence of coronary heart disease. Findings from the Systolic Hypertension in the Elderly Program (SHEP).
abstract: BACKGROUND
  The association of serum lipids with coronary heart disease has been studied extensively in middle-aged men and, to a lesser extent, in similar women. Less well defined are lipid variables predictive of CHD in individuals of age > or = 60 years.
  
  
  RESULTS
  The Systolic Hypertension in the Elderly Program recruited 4736 persons (mean age, 72 years; 14% were black; and 43% were men). Mean systolic and diastolic blood pressures were 170 and 77 mm Hg, respectively. Baseline mean total cholesterol was 6.11 mmol/L (236 mg/dL); HDL cholesterol, 1.39 mmol/L (54 mg/dL); and non-HDL cholesterol, 4.72 mmol/L (182 mg/dL). Triglyceride levels were 1.62 mmol/L (144 mg/dL) for fasting participants and 1.78 mmol/L for the total group. LDL cholesterol, estimated in fasting samples with triglycerides of < 4.52 mmol/L, averaged 3.98 mmol/L (154 mg/dL). Mean follow-up was 4.5 years. In multivariate Cox regression analyses, baseline total, non-HDL, and LDL cholesterol levels and the ratios of total, non-HDL, and LDL to HDL cholesterol were significantly related to CHD incidence. HDL cholesterol and triglycerides were not significant in these analyses. In fasting participants with triglyceride levels of < 4.52 mmol/L, a 1.03 mmol/L (40 mg/dL) higher baseline total, non-HDL, or LDL cholesterol was associated with a 30% to 35% higher CHD event rate.
  
  
  CONCLUSIONS
  The results of this study support the concept that serum lipids are CHD risk factors in older Americans.
authors.affiliation: Cardiovascular Research Institute, University of California, San Francisco 94143-0326, USA. phf@itsa.ucsf.edu
authors.forename: P H
authors.initials: PH
authors.lastname: Frost
authors.forename: B R
authors.initials: BR
authors.lastname: Davis
authors.forename: A J
authors.initials: AJ
authors.lastname: Burlando
authors.forename: J D
authors.initials: JD
authors.lastname: Curb
authors.forename: G P
authors.initials: GP
authors.lastname: Guthrie
authors.forename: J L
authors.initials: JL
authors.lastname: Isaacsohn
authors.forename: S
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.forename: A C
authors.initials: AC
authors.lastname: Wilson
authors.forename: J
authors.initials: J
authors.lastname: Stamler
mesh_terms: D000368:Aged; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D015994:Incidence; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013599:Systole
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D002784:Cholesterol