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Association of Serum Lipids and Coronary Heart Disease in Contemporary Observational Studies
Open accessAbstract
Background—: The use of statins increased among US adults with high coronary heart disease (CHD) risk after publication of the 2001 cholesterol treatment guidelines. Methods and Results—: We analyzed the association between lipids and CHD among 9578 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants and 346 595 Kaiser Permanente Southern California (KPSC) members with baseline lipid measurements in 2003 to 2007. We performed the same analyses among 14 590 Atherosclerosis Risk In Communities (ARIC) study participants with lipid measurements in 1987 to 1989. Analyses were restricted to blacks and whites 45 to 64 years of age without CHD who were not taking statins at baseline. Total cholesterol, high-density lipoprotein cholesterol, and triglycerides were measured at baseline. Low-density lipoprotein cholesterol, non–high-density lipoprotein cholesterol, and ratios of total to high-density lipoprotein cholesterol and triglycerides to high-density lipoprotein cholesterol were calculated. The prevalence of diabetes mellitus, history of stroke, and antihypertensive medication use increased at higher low-density lipoprotein cholesterol in ARIC but not in REGARDS or KPSC. Over 8.9 years of follow-up, 225 CHD events occurred in REGARDS, 6547 events in KPSC, and 583 events in ARIC. After multivariable adjustment, less favorable lipid levels were associated with higher hazard ratios for CHD in ARIC. These associations were attenuated in REGARDS and KPSC. For example, the hazard ratio associated with the highest versus lowest quartile of low-density lipoprotein cholesterol (≥146 versus ≤102 mg/dL) was 1.89 (95% confidence interval, 1.42–2.51) in ARIC, 1.25 (95% confidence interval, 0.81–1.92) in REGARDS, and 1.49 (95% confidence interval, 1.38–1.61) in KPSC. Conclusion—: The association between lipids and CHD in contemporary studies may be attenuated by the preferential use of statins by high-risk individuals.
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“Among the modifiable ones, elevated plasma low-density lipoprotein cholesterol (LDL-C) level is the most important [3].”
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Immunity and Inflammation in Atherosclerosis
Wolf, D., & Ley, K. F. (2019) · Circulation Research · doi:10.1161/circresaha.118.313591 · Cited by 1,798
T cell subsets and functions in atherosclerosis
Saigusa, R., Winkels, H., & Ley, K. (2020) · Nature Reviews Cardiology · doi:10.1038/s41569-020-0352-5 · Cited by 768
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Metadata
- Authors
- Colantonio, L. D., Bittner, V., Reynolds, K., Levitan, E. B., Rosenson, R. S., Banach, M., Kent, S. T., Derose, S. F., Zhou, H., Safford, M. M., & Muntner, P.
- Affiliations
- Kaiser Permanente (US)
- ORCID
- Venue
- Circulation
- Published
- 2016-01-19
- Volume
- 133
- Issue
- 3
- Pages
- 256-264
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC4718875
- OpenAlex
- W2274399838
- Cited by
- 105
- References
- 51
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 15 · 2020: 10 · 2019: 9 · 2018: 9 · 2017: 18 · 2016: 12
- FWCI
- 13.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL080477, K24HL111154)
- National Institute of Neurological Disorders and Stroke (U01NS041588)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › 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
- coronary artery disease, serum lipids, LDL cholesterol, statin use, triglycerides, HDL cholesterol, non-HDL cholesterol, triglyceride to HDL cholesterol ratio, REGARDS study, Atherosclerosis Risk in Communities Study, Kaiser Permanente Southern California, diabetes mellitus, antihypertensive medication use
- MeSH terms
- Cholesterol, Coronary Artery Disease, Female, Humans, Lipoproteins, Lipoproteins, HDL, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Risk Factors, Triglycerides, Southeastern United States, Observational Studies as Topic
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