title: Predictors of 14-year changes in the total cholesterol to high-density lipoprotein cholesterol ratio in men.
abstract: BACKGROUND
  Although the ratio of total to high-density lipoprotein cholesterol (TC/HDL) is a powerful predictor of cardiovascular disease (CVD), few studies have investigated which factors are associated with changes in this ratio over time. We examined predictors of a change in TC/HDL ratio over a period of 14 years among 4451 men free of CVD from the Physicians' Health Study.
  
  
  METHODS
  Baseline and updated physician characteristics and CVD risk factors were included in multivariate linear and logistic regression models to determine factors associated with a change in the TC/HDL ratio or of having a ratio of > or =5 on follow-up.
  
  
  RESULTS
  After a mean follow-up of 14 years, mean total cholesterol decreased by 7 mg/dL, HDL increased by 1 mg/dL, and the ratio decreased by 0.37. In multivariate logistic analyses, physicians were more likely to have a TC/HDL ratio of > or =5 at follow-up if they maintained a weight of > or =25 kg/m2 (OR, 1.69 [1.35-2.12]), gained weight (OR, 2.01 [1.55-2.62]), or became inactive (OR, 1.43 [1.11-1.83]). However, older physicians and those who consumed alcohol or received treatment for hyperlipidemia were more likely to have a ratio of <5.
  
  
  CONCLUSIONS
  Although pharmacologic treatment for hyperlipidemia had the greatest favorable impact on the ratio over time, our data also show that maintaining an ideal weight and exercise have beneficial effects. We therefore advocate a renewed fervor for raising public awareness of the benefits of healthy lifestyle behaviors and pharmacologic treatments that are associated with long-term maintenance of favorable cholesterol levels.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA. richardscrantonmd@rcn.com
authors.forename: Richard
authors.initials: R
authors.lastname: Scranton
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: James W
authors.initials: JW
authors.lastname: Levenson
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D001241:Aspirin / Q000008:administration & dosage; D001835:Body Weight; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D015897:Comorbidity; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010820:Physicians / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011322:Primary Prevention / Q000706:statistics & numerical data*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D019207:beta Carotene / Q000008:administration & dosage
chemical_list: D008076:Cholesterol, HDL; D019207:beta Carotene; D002784:Cholesterol; D001241:Aspirin