Prospective association between low and high total and low-density lipoprotein cholesterol and coronary heart disease in elderly men.
OBJECTIVE
To examine the relationship between total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and the incidence of coronary heart disease (CHD) in elderly men.


METHODS
Prospective.


METHODS
Population based.


METHODS
A sample of 2,424, Japanese-American men aged 71 to 93 was used.


METHODS
Six years of data on incident fatal plus nonfatal CHD were examined.


RESULTS
Analysis revealed a significant U-shaped relationship between age-adjusted CHD rates and both TC and LDL-C. The ranges of TC and LDL-C with the lowest risk of CHD were 200 to 219 mg/dL and 120 to 139 mg/dL, respectively. As cholesterol concentrations declined and increased beyond these ranges, the risk of CHD increased. These U-shaped relationships remained significant after adjusting for age and other risk factors.


CONCLUSIONS
The U-shaped associations between TC and LDL-C and CHD imply a complex relationship between lipids and CHD in late life. The results indicate that elevated lipid levels should continue to be treated in healthy elderly individuals, as they are in those who are younger, although pharmacologically lowering lipids to excessively low levels in the elderly may warrant further study, as does the contribution of subclinical frailty to the relationship of lipids to CHD risk.
Curb
J David
JD
Honolulu Heart Program, Kuakini Medical Center, Honolulu, Hawaii, USA. jdcurb@phrihawaii.org
Abbott
Robert D
RD
Rodriguez
Beatriz L
BL
Masaki
Kamal
K
Popper
Jordan
J
Chen
Randi
R
Petrovitch
Helen
H
Blanchette
Patricia
P
Schatz
Irwin
I
Yano
Katsuhiko
K
D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology*; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications*; D015994:Incidence; D007564:Japan / Q000208:ethnology; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk
D008078:Cholesterol, LDL; D002784:Cholesterol