Effect of Change in Total Cholesterol Levels on Cardiovascular Disease Among Young Adults

Abstract

BackgroundAlthough high serum cholesterol in young adults is known to be a predictor for cardiovascular events, there is not enough evidence for the association of cholesterol level change with cardiovascular disease (CVD). This study aimed to evaluate whether the change in cholesterol is associated with incidence of CVD among young adults.Methods and ResultsWe examined 2 682 045 young adults (aged 20–39 years) who had undergone 2 consecutive national health check‐ups provided by Korean National Health Insurance Service between 2002 and 2005. Cholesterol levels were classified into low (<180 mg/dL), middle (180–240 mg/dL) and high (≥240 mg/dL). CVD events were defined as ≥2 days hospitalization attributable to CVD for 10 years follow‐up. Increased cholesterol levels were significantly associated with elevated ischemic heart disease risk (adjusted hazard ration [aHR]=1.21; 95% confidence interval [CI]=1.03–1.42 in low‐high group and aHR=1.21; 95% CI=1.15–1.27 in middle‐high group) and cerebrovascular disease (CEVD) risk (aHR=1.24; 95% CI=1.05–1.47 in low‐high group and aHR=1.09; 95% CI=1.02–1.16 in middle‐high group). Decreased cholesterol levels were associated with reduced ischemic heart disease risk (aHR=0.91; 95% CI=0.88–0.95 in middle‐low group, aHR=0.65; 95% CI=0.56–0.75 in high‐low group and aHR=0.68; 95% CI=0.65–0.73 in high‐middle group). Furthermore, lower cerebrovascular disease risk (aHR=0.76; 95% CI=0.62–0.92) was observed in the high‐low group compared with patients with sustained high cholesterol.ConclusionsThe findings of our study indicate that increased cholesterol levels were associated with high CVD risk in young adults. Furthermore, young adults with decreased cholesterol levels had reduced risk for CVD.

Appropriate Total cholesterol cut-offs for detection of abnormal LDL cholesterol and non-HDL cholesterol among low cardiovascular risk population

“…However, the study by Zhang only had access to laboratory results and did not have access to past medical history and physical examination, which may not be generalizable to healthy populations or those with low cardiovascular risks. Our suggested cut off point of 210 is line with other previous studies [25, 26] that showed TC cutoff range from 200 to 210 mg/dL was appropriate for early intervention while the TC cutoff point of 230 to identify those at high risk is also supported by the literature in a large population study with 10-year follow up [27, 28]. These studies demonstrated that a higher risk of ischemic heart disease was found in the high cholesterol group with a TC level ≥ 240 mg/dL.…”

Efficacy and Tolerability of Pitavastatin Versus Pitavastatin/Fenofibrate in High-risk Korean Patients with Mixed Dyslipidemia: A Multicenter, Randomized, Double-blinded, Parallel, Therapeutic Confirmatory Clinical Trial

“…9 Dyslipidemia is known as the main cause of CVD, and the first-line goal in reducing CVD-related morbidity is to lower LDL-C. 15 However, several studies have indicated that elevated levels of not only LDL-C but also other blood lipids (TC, TG, and VLDL) are risk factors for CVD, and that controlling these lipid levels will further reduce CVD-related morbidity. 4,17,18 In the present study, reductions from baseline in TC, TG, and VLDL-C levels at weeks 4 and 8 were significantly greater with the pitavastatin/fenofibrate combination therapy compared to those with pitavastatin monotherapy. In particular, TG and VLDL-C levels at weeks 4 and 8 were significantly reduced compared to the baseline levels.…”

The relationship between counselling methods after health check-ups and lipid profile improvement: a retrospective cohort study in Korea

“…In addition, this study did not consider that the goals and treatment methods associated with dyslipidaemia differ according to levels of cardiovascular risks. However, in a recent study [16] of young adults aged 20 to 39 years in Korea, the risks of ischaemic heart disease and cerebrovascular disease were reduced if total cholesterol levels were reduced to a lower class than was observed in the previous examination, when dividing total cholesterol levels into the following categories: low (< 180 mg/dL), middle (180-240 mg/dL), high (≥ 240 mg/dL). Therefore, it is meaningful to compare the degree of change in cholesterol levels alone, as was done in the current study.…”