title: Age and Cardiovascular Risk Attributable to Apolipoprotein B, Low-Density Lipoprotein Cholesterol or Non-High-Density Lipoprotein Cholesterol.
abstract: Higher concentrations of the apolipoprotein B (apoB) lipoproteins increase the risk of cardiovascular disease. However, whether the risk associated with apoB lipoproteins varies with age has not been well examined.
  
  
  
  We determined the associations for total cholesterol, low-density lipoprotein (LDL)-cholesterol (LDL-C), non-high-density lipoprotein-cholesterol (non-HDL-C), apoB, apolipoprotein A-I (apoA-I), and HDL-cholesterol (HDL-C) with myocardial infarction at different ages in 11 760 controls and 8998 myocardial infarction cases of the INTERHEART Study. Logistic regression was used to compute the odds ratio of myocardial infarction for 1 SD change in each lipid marker by decade from <40 to >70 years of age. Except for those >70, plasma levels of total cholesterol, LDL-C, and non-HDL-C and apoB were greater in cases than controls. However, the average levels of these markers decreased significantly as age increased. By contrast, levels of apoA-I and HDL-C were significantly greater in controls than cases but increased significantly as age increased. The cardiovascular risk associated with the atherogenic lipid markers differed at different ages. Most notably, there was a significant decline in the odds ratio for total cholesterol, LDL-C, and non-HDL-C, and apoB with increases in age whereas the odds ratios associated with apoA-I and HDL-C were consistent across the age groups.
  
  
  
  These data indicate that the risk of cardiovascular events associated with apoB particles is greater in younger compared to older individuals. This finding is consistent with greater relative benefit from LDL-lowering therapy in younger compared to older individuals and so argues for therapy in younger individuals with elevated lipids.
authors.affiliation: McGill University, Montreal, Canada allansniderman@hotmail.com.
authors.forename: Allan D
authors.initials: AD
authors.lastname: Sniderman
authors.affiliation: Population Research Institute and McMaster University, Hamilton, Canada.
authors.forename: Shofiqul
authors.initials: S
authors.lastname: Islam
authors.affiliation: Population Research Institute and McMaster University, Hamilton, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: McQueen
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Michael
authors.initials: M
authors.lastname: Pencina
authors.affiliation: Public Health Sciences, Wake Forest University, Winston-Salem, NC.
authors.forename: Curt D
authors.initials: CD
authors.lastname: Furberg
authors.affiliation: McGill University, Montreal, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Thanassoulis
authors.affiliation: Population Research Institute and McMaster University, Hamilton, Canada.
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood*; D053299:Apolipoprotein B-100 / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000453:epidemiology; D016017:Odds Ratio
chemical_list: C569471:APOB protein, human; D016632:Apolipoprotein A-I; D053299:Apolipoprotein B-100; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL
keywords: apolipoprotein B; cardiovascular events; low‐density lipoprotein cholesterol; non‐high‐density lipoprotein cholesterol; primary prevention; risk assessment; risk factor; risk prediction