Predictors of 14-year changes in the total cholesterol to high-density lipoprotein cholesterol ratio in men.
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.
Scranton
Richard
R
Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA. richardscrantonmd@rcn.com
Sesso
Howard D
HD
Stampfer
Meir J
MJ
Levenson
James W
JW
Buring
Julie E
JE
Gaziano
J Michael
JM
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
D008076:Cholesterol, HDL; D019207:beta Carotene; D002784:Cholesterol; D001241:Aspirin