title: High-density lipoprotein and mortality before age 90 in male physicians.
abstract: BACKGROUND
  In cross-sectional and some cohort studies with shorter follow-up, high-density lipoprotein cholesterol (HDL-C) has been associated with longer life. We sought to examine the relationship between HDL-C and death before age 90 in the Physicians' Health Study (PHS).
  
  
  RESULTS
  Of PHS enrollees who had blood collected at PHS II baseline (approximately 1997), we selected 1351 men old enough to reach age 90 by March 4, 2009, and with complete data on HDL-C and total cholesterol, lifestyle factors, and comorbidities. We used Cox proportional hazards to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cardiovascular disease (CVD), and non-CVD mortality before age 90, adjusting for potential confounders. After a mean (SD) follow-up of 6.8 (3.2) years, 44.1% of men in the lowest baseline HDL-C quartile (<32.8 mg/dL) compared with 32.9% (11.2% absolute risk reduction) in the highest HDL-C quartile (≥ 54.1 mg/dL) died before age 90. In multivariable adjusted analyses, men in the highest HDL-C quartile had a 28% lower risk (HR, 0.72; 95% CI, 0.55 to 0.94) of death before age 90 compared with men in the lowest HDL-C quartile. In age-adjusted analyses, increasing baseline HDL-C was significantly associated with a lower risk of CVD death. No association was found between HDL-C and non-CVD mortality.
  
  
  CONCLUSIONS
  In male physicians, higher baseline HDL-C levels were associated with a lower risk of all-cause and CVD mortality before age 90.
authors.affiliation: Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA. crahilly-tierney@partners.org
authors.forename: Catherine
authors.initials: C
authors.lastname: Rahilly-Tierney
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.forename: J
authors.initials: J
authors.lastname: Michael Gaziano
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death; D015897:Comorbidity; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008075:Lipoproteins, HDL / Q000097:blood*; D008136:Longevity; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D008075:Lipoproteins, HDL