Clarifying the Direct Relation between Total Cholesterol Levels and Death from Coronary Heart Disease in Older Persons

Corti, Maria Chiara; Guralnik, Jack M.; Salive, Marcel E.; Harris, Tamara B.; Ferrucci, Luigi; Glynn, Robert J.; Havlik, Richard J.

doi:10.7326/0003-4819-126-10-199705150-00001

Cited by 219 publications

(116 citation statements)

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“…high HDL-C, low LDL-C, and low TG levels) being associated with the risk of cognitive decline. Such lipidic pattern is associated with inflammation, poor nutritional status, and frailty (Corti et al, 1997;Hu et al, 2003) and may thus reflect a change in dietary habits accompanying pathology and/or be a marker for early neurodegenerative changes. In our previous study, TG levels were found associated with a decreased risk of…”

Section: Discussionmentioning

confidence: 99%

Gender-specific associations between lipids and cognitive decline in the elderly

Ancelin

Ripoche

Dupuy

et al. 2014

European Neuropsychopharmacology

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The aim of this study was to examine the associations between serum lipid levels and cognitive function in a community-based sample of non-demented subjects aged 65 years and over.Participants were 2737 men and 4118 women from a population-based cohort recruited from three French cities. Visual memory, verbal fluency, psychomotor speed, and executive abilities were evaluated at baseline, and after 2, 4, and 7 years of follow-up. Lipid levels were evaluated at baseline. Multiadjusted Cox models stratified by gender were adjusted for sociodemographic and lifestyle characteristics, mental and physical health, and genetic vulnerability to dyslipidemia (apolipoprotein E and A, and cholesteryl ester transfer protein) and taking into account baseline vascular pathologies. In men, a hypercholesterolemic pattern in late-life (high total cholesterol (T-C), low HDL-C, high LDL-C levels) was associated with a 25 to 50% increased risk of decline over 7 years in psychomotor speed, executive abilities, and verbal fluency. Specific associations with low T-C and low LDL-C levels were also observed which may depend on genetic vulnerability to dyslipidemia (related to apolipoprotein A5 and cholesteryl exchange transfer protein). In contrast, in women, a 30% higher rate of decline was found in psychomotor speed with high HDL-C levels and in executive abilities with low levels of LDL-C and triglycerides, in interaction with hormonal treatment. For men and women, vascular pathologies only slightly outweighed the risk related to lipids. This suggests a complex gender-specific pattern of cognitive decline involving genetic vulnerability in men and hormonal status in women.

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Section: Discussionmentioning

confidence: 99%

Gender-specific associations between lipids and cognitive decline in the elderly

Ancelin

Ripoche

Dupuy

et al. 2014

European Neuropsychopharmacology

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“…Whereas low HDL-cholesterol is predictive of cardiovascular disease even among people >70 years old [29,30], observational studies in the elderly have either shown no predictive effect of plasma LDL-cholesterol or a protective effect of higher concentrations [3][4][5][6]. In a large population-based cohort of elderly people in the USA, 20% of whom had diabetes, the protective effect of higher concentrations of total choles- terol disappeared after adjustment for markers of poor health, suggesting confounding effects of comorbidity and frailty [5]. In the Honolulu Heart Program, in which 3,572 Japanese American men were followed-up prospectively for 20 years, significantly decreasing age-adjusted mortality rates were found for the upper vs the lower quartiles of cholesterol concentrations, particularly in men with persistently low cholesterol values in consecutive examinations [3].…”

Section: Discussionmentioning

confidence: 99%

“…This association is weaker in older people, with an apparent paradoxical protective effect of high concentrations of cholesterol in some observational studies [2][3][4][5][6][7]. Measurement of plasma apolipoprotein (Apo) B and ApoA-I improves the prediction of cardiovascular disease, allowing identification of high-risk individuals who are not identified by the standard lipid profile [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Effect of age on the association of non-high-density-lipoprotein cholesterol and apolipoprotein B with cardiovascular mortality in a Mediterranean population with type 2 diabetes: the Casale Monferrato study

et al. 2006

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Aims/hypothesis: Measurement of plasma apolipoprotein (Apo) B may improve prediction of cardiovascular risk, as it provides a measure of the total number of atherogenic particles. The aim of this population-based study was to compare the association of non-HDLcholesterol, ApoB and the ApoB:ApoA-I ratio with cardiovascular mortality in people with type 2 diabetes. Subjects and methods: We assessed the association of lipids, lipoprotein lipids and apolipoproteins with 11-year mortality from cardiovascular disease in the populationbased cohort of the Casale Monferrato Study (1,565 people with diabetes; median age 68.9 years), and determined the effect of age (≤70 and >70 years) on these relationships. Results: On the basis of 341 deaths from cardiovascular disease in 10,809 person-years of observation, there was a decreasing trend in risk adjusted for multiple factors across quartiles of total cholesterol, and LDL-and non-HDL-cholesterol in people aged >70 years, but no trend in those aged ≤70 years. Age did not affect the protective effect of HDL-cholesterol. ApoB and ApoB:ApoA-I were associated with outcome in people in both age groups independently of non-HDLcholesterol. After adjustment for multiple factors, including non-HDL-cholesterol, the hazard ratios for ApoB: ApoA-I in the upper vs lower quartile were 2.98 (95% CI 1.15-7.75; p for trend=0.009) for people aged ≤70 years and 1.94 (95% CI 1.20-3.13; p for trend=0.003) for those aged >70 years. Conclusions/interpretation: In this cohort of Mediterranean subjects with diabetes, ApoB and the ApoB:ApoA-I ratio were associated with cardiovascular disease mortality independently of non-HDLcholesterol. Our findings support the recommendation that ApoB and ApoA-I should be measured routinely in all people with diabetes, particularly in the elderly.

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“…Corti et al 14 concluded from the EPESE data that abnormal cholesterol levels are associated with CVD death in the elderly, and that their exclusion from studies that evaluate the relationship between cholesterol and CVD is improper. In "The Northern Manhattan Study" 15 , the authors infer that high HDL-c is associated with a reduced risk of ischemic stroke in the elderly, and they considered HDL-c as an important modifiable RF for stroke.…”

Section: Introductionmentioning

confidence: 99%

Importância da HDL-c para a ocorrência de doença cardiovascular no idoso

Freitas¹,

Brandão²,

Pozzan³

et al. 2009

Arq. Bras. Cardiol.

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Clarifying the Direct Relation between Total Cholesterol Levels and Death from Coronary Heart Disease in Older Persons

Cited by 219 publications

References 0 publications

Gender-specific associations between lipids and cognitive decline in the elderly

Gender-specific associations between lipids and cognitive decline in the elderly

Effect of age on the association of non-high-density-lipoprotein cholesterol and apolipoprotein B with cardiovascular mortality in a Mediterranean population with type 2 diabetes: the Casale Monferrato study

Importância da HDL-c para a ocorrência de doença cardiovascular no idoso

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