Low-density lipoprotein cholesterol and mortality in older people.
OBJECTIVE
To investigate the role of low-density lipoprotein cholesterol (LDL-C) as a predictor of mortality in elderly subjects.


METHODS
Population-based prospective cohort study.


METHODS
Two communities in northern Italy.


METHODS
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.


METHODS
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.


CONCLUSIONS
This study adds to the uncertainty of the role of elevated levels of LDL-C as a risk factor for mortality in old people.
Tikhonoff
Valérie
V
Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
Casiglia
Edoardo
E
Mazza
Alberto
A
Scarpa
Roberta
R
Thijs
Lutgarde
L
Pessina
Achille C
AC
Staessen
Jan A
JA
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009026:Mortality; D009203:Myocardial Infarction / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000401:mortality
D008078:Cholesterol, LDL