Plasma Lipoprotein Levels as Predictors of Cardiovascular Death in Women
Abstract
BACKGROUND: The association of lipoprotein levels with cardiovascular disease (CVD) is less well understood in women than in men. To better characterize any relationships, associations between CVD death and total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol and triglyceride levels in women were explored using data from female participants in the Lipid Research Clinics' Follow-up Study. METHODS: Using a sample of 1405 women aged 50 to 69 years from the Lipid Research Clinics' Follow-up Study, age-adjusted CVD death rates and summary relative risk (RR) estimates by categories of lipid and lipoprotein levels were calculated. Multivariate analysis was performed to provide RR estimates adjusted for other CVD risk factors. RESULTS: Average follow-up was 14 years. High-density lipoprotein and triglyceride levels were strong predictors of CVD death in age-adjusted and multivariate analyses. Low-density lipoprotein and total cholesterol levels were poorer predictors of CVD mortality. After adjustment for other CVD risk factors, HDL levels less than 1.30 mmol/L (50 mg/dL) were strongly associated with cardiovascular mortality (RR = 1.74; 95% confidence interval [CI], 1.10 to 2.75). Triglyceride levels were associated with increased CVD mortality at levels of 2.25 to 4.49 mmol/L (200 to 399 mg/dL) (RR = 1.65; 95% CI, 0.99 to 2.77) and 4.50 mmol/L (400 mg/dL) or greater (RR = 3.44; 95% CI, 1.65 to 7.20). At total cholesterol levels of 5.20 mmol/L (200 mg/dL) or greater and at all levels of LDL and triglycerides, women with HDL levels of less than 1.30 mmol/L (< 50 mg/dL) had CVD death rates that were higher than those of women with HDL levels of 1.30 mmol/L (50 mg/dL) or greater. CONCLUSIONS: High-density lipoprotein and triglyceride levels are independent lipid predictors of CVD death in women. Cholesterol screening guidelines should be re-evaluated to reflect the importance of HDL and triglyceride levels in determining CVD risk in women.
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Triglycerides are independent predictors of CVD mortality in women.
“Triglycerides are independent predictors of CVD mortality in women [143]; however, the magnitude of the observed exercise-induced triglyceride reduction, within the reported range, is likely to have little clinical relevance.”
From Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis (2019) · cites this paper as [143]
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Edmunds, E. (2000) · QJM · doi:10.1093/qjmed/93.3.135 · Cited by 53 · see citing works
Lipids and Lipoproteins in Women
O’Brien, T., & Nguyen, T. T. (1997) · Mayo Clinic Proceedings · doi:10.4065/72.3.235 · Cited by 53 · see citing works
Sbarouni, E., Kyriakides, Z. S., & Kremastinos, D. T. H. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00413-6 · Cited by 52 · see citing works
Gender considerations in hypertension pathophysiology and treatment
Hanes, D. S., Weir, M. R., & Sowers, J. R. (1996) · The American Journal of Medicine · doi:10.1016/s0002-9343(96)00264-1 · Cited by 51 · see citing works
Dietary macronutrients, genetic variation, and progression of coronary atherosclerosis among women
Kalantarian, S., Rimm, E. B., Herrington, D. M., & Mozaffarian, D. (2014) · American Heart Journal · doi:10.1016/j.ahj.2014.01.001 · Cited by 8 · see citing works
- Authors
- Bass, K. M.
- Corresponding author
- Bass, Katherine Miller
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 1993-10-11
- Volume
- 153
- Issue
- 19
- Pages
- 2209
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W4249253717
- Cited by
- 331
- References
- 0
- Citations by year
- 2024: 3 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 6 · 2017: 5 · 2016: 7 · 2015: 11 · 2014: 9 · 2013: 8 · 2012: 10
- FWCI
- 19.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL 07024, T32HL007024)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- serum lipoproteins, cardiovascular mortality, women, mortality prediction, serum lipids, cardiovascular risk
- MeSH terms
- Age Factors, Aged, Cardiovascular Diseases, Female, Humans, Lipoproteins, Cholesterol, HDL, Cholesterol, LDL, Middle Aged, Predictive Value of Tests, Triglycerides, Multivariate Analysis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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