Elevated LDL cholesterol and increased risk of myocardial infarction and atherosclerotic cardiovascular disease in individuals aged 70-100 years: a contemporary primary prevention cohort
Abstract
Background Findings of historical studies suggest that elevated LDL cholesterol is not associated with increased risk of myocardial infarction and atherosclerotic cardiovascular disease in patients older than 70 years. We aimed to test this hypothesis in a contemporary population of individuals aged 70-100 years. Methods We included in our analysis individuals (aged 20-100 years) from the Copenhagen General Population Study (CGPS) who did not have atherosclerotic cardiovascular disease or diabetes at baseline and who were not taking statins. Standard hospital assays were used to measure LDL cholesterol. We calculated hazard ratios (HRs) and absolute event rates for myocardial infarction and atherosclerotic cardiovascular disease, and we estimated the number needed to treat (NNT) in 5 years to prevent one event. Findings Between Nov 25, 2003, and Feb 17, 2015, 91 131 individuals were enrolled in CGPS. During mean 7·7 (SD 3·2) years of follow-up (to Dec 7, 2018), 1515 individuals had a first myocardial infarction and 3389 had atherosclerotic cardiovascular disease. Risk of myocardial infarction per 1·0 mmol/L increase in LDL cholesterol was augmented for the overall population (HR 1·34, 95% CI 1·27-1·41) and was amplified for all age groups, particularly those aged 70-100 years. Risk of atherosclerotic cardiovascular disease was also raised per 1·0 mmol/L increase in LDL cholesterol overall (HR 1·16, 95% CI 1·12-1·21) and in all age groups, particularly those aged 70-100 years.…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Elevated low-density lipoprotein cholesterol is a major causal factor in atherosclerotic cardiovascular disease.
“Elevated low-density lipoprotein cholesterol (LDL-C) is a major causal factor in atherosclerotic cardiovascular disease (ASCVD).1”
From Small Interfering RNA for LDL-Cholesterol Reduction (2026) · cites this paper as [1]
Cites
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw272 · Cited by 3,162 · see citing works
Genetically Elevated Lipoprotein(a) and Increased Risk of Myocardial Infarction
Kamstrup, P. R. (2009) · JAMA · doi:10.1001/jama.2009.801 · Cited by 1,357 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Benetos, A., Biffi, A., Boavida, J.-M., Capodanno, D., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab484 · Cited by 6,485 · see citing works
Longevity leap: mind the healthspan gap
Garmany, A., Yamada, S., & Terzic, A. (2021) · npj Regenerative Medicine · doi:10.1038/s41536-021-00169-5 · Cited by 252 · see citing works
Sex differences in lipids: a life course approach
Holven, K. B., & Roeters van Lennep, J. (2023) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2023.117270 · Cited by 180 · see citing works
Agolino, G., Pino, A., Vaccalluzzo, A., Cristofolini, M., Solieri, L., Caggia, C., & Randazzo, C. L. (2024) · Journal of Functional Foods · doi:10.1016/j.jff.2024.106357 · Cited by 87 · see citing works
Small Interfering RNA for LDL-Cholesterol Reduction
Batista, F., Mamede, I., & Dacoregio, M. (2026) · JACC: Advances · doi:10.1016/j.jacadv.2026.102932
- Authors
- Mortensen, M. B., & Nordestgaard, B. G.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Nordestgaard, Børge Grønne
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 396
- Issue
- 10263
- Pages
- 1644-1652
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W3103183776
- Cited by
- 290
- References
- 2
- Citations by year
- 2026: 31 · 2025: 47 · 2024: 50 · 2023: 69 · 2022: 50 · 2021: 41 · 2020: 2
- FWCI
- 36.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- Funders
- Herlev Hospital
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- myocardial infarction, atherosclerotic cardiovascular disease, older adults, oldest old, familial hypercholesterolemia, primary prevention, statin therapy, cardiovascular risk, number needed to treat, Copenhagen General Population Study, hypercholesterolemia, age-specific risk, cardiovascular mortality, cardiovascular hospitalization
- MeSH terms
- Aged, Aged, 80 and over, Arteriosclerosis, Cardiovascular Diseases, Denmark, Female, Humans, Cholesterol, LDL, Male, Middle Aged, Myocardial Infarction, Primary Prevention, Risk Factors, Cohort Studies
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
