title: Longitudinal changes in high-density lipoprotein cholesterol and cardiovascular events in older adults.
abstract: OBJECTIVE
  While low high-density lipoprotein cholesterol (HDL-C) is associated with increased risk of cardiovascular (CV) events, there are limited data evaluating the association of longitudinal change in HDL-C with CV event risk in older populations. The aim of this study was to examine the association between within-subject changes in HDL-C levels and CV events in an older population.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  1293 men and 1422 women age ≥50 years, with ≥2 consecutive HDL measurements, and no prior CVD as part of Framingham Offspring Study.
  
  
  METHODS
  A clinical CV event was defined as the first occurrence of any of the following: coronary heart disease (coronary death, myocardial infarction, coronary insufficiency and angina), cerebrovascular event, peripheral artery disease or heart failure.
  
  
  RESULTS
  Median total follow-up time across subjects was 9·6 years. Change in HDL-C was evaluated as between-exam (approximately 3·5 years) percentage change in HDL-C, categorized as ≥10% decrease, <10% change (stable) and ≥10% increase. Crude and adjusted sex-specific Cox hazards regression models with change in HDL-C as a time-dependent covariate quantified the association with CV events. Mean baseline age of the analysis sample was 53 years. There were 233 and 111 CV events among men and women, respectively. Change in HDL-C was not significantly associated with CVD incidence in men or women, without or with adjustment for confounders including baseline HDL-C or use of relevant medications.
  
  
  CONCLUSIONS
  In conclusion, relatively short-term (3·5 years) changes in HDL-C levels do not affect CV events in men and women.
authors.affiliation: Department of Epidemiology, New England Research Institutes Inc., Watertown, MA, USA.
authors.forename: Andre B
authors.initials: AB
authors.lastname: Araujo
authors.forename: Gretchen R
authors.initials: GR
authors.lastname: Chiu
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Christian
authors.forename: Hae Young
authors.initials: HY
authors.lastname: Kim
authors.forename: William J
authors.initials: WJ
authors.lastname: Evans
authors.forename: Richard V
authors.initials: RV
authors.lastname: Clark
mesh_terms: D000368:Aged; D000375:Aging; D002318:Cardiovascular Diseases / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000097:blood; D016016:Proportional Hazards Models; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008076:Cholesterol, HDL