High-Density vs Low-Density Lipoprotein Cholesterol as the Risk Factor for Coronary Artery Disease and Stroke in Old Age
Abstract
Background A high total serum cholesterol level does not carry a risk of cardiovascular mortality among people 85 years and older and is related to decreased all-cause mortality. At this old age, there are few data on fractionated lipoprotein levels in the determination of cardiovascular disease risk. The aim of this study was to evaluate the relationships between low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels and mortality from specific causes among people in the oldest age categories. Methods Between September 1, 1997, and September 1, 1999, a total of 705 inhabitants in the community of Leiden, the Netherlands, reached the age of 85 years. Among these old people, we initiated a prospective follow-up study to investigate determinants of successful aging. A total of 599 subjects participated (response rate, 87%) and all were followed up to September 2001. Serum levels of total, LDL, and HDL cholesterol were assessed at baseline along with detailed information on comorbid conditions. The main outcome measure was all-cause and specific mortality risk. Results During 4 years of follow-up, 152 subjects died. The leading cause of death was cardiovascular disease, with similar mortality risks in all tertiles of LDL cholesterol level. In contrast, low HDL cholesterol level was associated with a 2.0-fold higher risk of fatal cardiovascular disease (95% confidence interval [CI], 1.2-3.2). The mortality risk of coronary artery disease was 2.0 (95%…
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In old age, only levels of HDL cholesterol, but not total cholesterol, LDL cholesterol, and triglycerides, affect cardiovascular disease risk.
“In contrast, in old age, only levels of HDL cholesterol, but not of total cholesterol, LDL cholesterol, and triglycerides, affect cardiovascular disease risk [ 12, 32, 38, 39].”
From ApoE Plasma Levels and Risk of Cardiovascular Mortality in Old Age (2006) · cites this paper as [12]
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Cooney, M. T., Dudina, A., De Bacquer, D., Wilhelmsen, L., Sans, S., Menotti, A., De Backer, G., Jousilahti, P., Keil, U., Thomsen, T., et al. (2009) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2009.02.041 · Cited by 250 · see citing works
ApoE Plasma Levels and Risk of Cardiovascular Mortality in Old Age
Mooijaart, S. P., Berbée, J. F. P., van Heemst, D., Havekes, L. M., de Craen, A. J. M., Slagboom, P. E., Rensen, P. C. N., & Westendorp, R. G. J. (2006) · PLoS Medicine · doi:10.1371/journal.pmed.0030176 · Cited by 129 · see citing works
Self-citationPlasma levels of apolipoprotein E and risk of ischemic heart disease in the general population
Rasmussen, K. L., Tybjærg-Hansen, A., Nordestgaard, B. G., & Frikke-Schmidt, R. (2016) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2015.12.038 · Cited by 47 · see citing works
- Authors
- Weverling-Rijnsburger, A. W. E., Jonkers, I. J. A. M., van Exel, E., Gussekloo, J., & Westendorp, R. G. J.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2003-07-14
- Volume
- 163
- Issue
- 13
- Pages
- 1549
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2021391816
- Cited by
- 199
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 16 · 2022: 8 · 2021: 7 · 2020: 9 · 2019: 5 · 2018: 7 · 2017: 9 · 2016: 5 · 2015: 9 · 2014: 8 · 2013: 13 · 2012: 10
- FWCI
- 9.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- HDL cholesterol, LDL cholesterol, lipoprotein cholesterol, coronary artery disease, stroke, cardiovascular mortality, all-cause mortality, oldest old, successful aging, infection-related mortality, comorbidities, cardiovascular risk factors
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Coronary Disease, Female, Follow-Up Studies, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Netherlands, Prospective Studies, Risk Factors, Proportional Hazards Models, Stroke
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