HDL cholesterol predicts coronary heart disease mortality in older persons

Corti, Maria Chiara

doi:10.1001/jama.274.7.539

Cited by 101 publications

(99 citation statements)

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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].…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…It has been also reported that low HDL-C levels represent one of the most prevalent lipid abnormality in the subjects affected by CHD [3,4], and unlike high total cholesterol (TC) levels, low HDL-C levels seem to maintain a significant predictive value for CHD in the older population [5]. Therefore, several recent guidelines [6][7][8] consider low HDL-C levels a strong and independent risk factor for CHD.…”

Section: Introductionmentioning

confidence: 99%

High interleukin-6 plasma levels are associated with low HDL-C levels in community-dwelling older adults: The InChianti study

et al. 2007

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“…[1][2][3] Low levels of HDL cholesterol are associated with significantly increased risk of CHD. 4 Genetic syndromes of high HDL are associated with longevity and decreased incidence of CHD.…”

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confidence: 99%

Regression of Atherosclerosis Induced by Liver-Directed Gene Transfer of Apolipoprotein A-I in Mice

et al. 1999

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Background-The ability of apolipoprotein (apo)A-I to induce regression of preexisting atherosclerotic lesions has not been determined, and a mouse model of atherosclerosis regression has not yet been reported. Methods and Results-LDL receptor-deficient mice were fed a western-type diet for 5 weeks to induce atherosclerotic lesions. A second-generation recombinant adenovirus encoding human apoA-I or a control adenovirus were injected intravenously in order to express apoA-I in the liver. Three days after injection, total apoA-I levels in mice injected with the apoA-I-expressing adenovirus were 216Ϯ16.0 mg/dL, compared with 68.0Ϯ3.0 mg/dL in control virus-injected mice (PϽ0.001). HDL cholesterol levels in mice injected with the AdhapoA-I vector 7 days after injection were 189Ϯ21.0 mg/dL, compared with 123Ϯ8.0 mg/dL in control virus-injected mice (PϽ0.02). Total and non-HDL cholesterol levels did not differ between the 2 groups. Atherosclerotic lesion area was quantified by en face analysis of the aorta and cross-sectional analysis of the aortic root. Compared with baseline mice, atherosclerosis progressed in mice injected with the control adenovirus. In contrast, in mice expressing apoA-I compared with baseline mice, total en face aortic lesion area was reduced by 70% and aortic root lesion was reduced by 46%. Expression of apoA-I was associated with a significant reduction in the fraction of lesions occupied by macrophages and macrophage-derived foam cells. Conclusions-Liver-directed gene transfer of human apoA-I resulted in significant regression of preexisting atherosclerotic lesions in LDL receptor-deficient mice as assessed by 2 independent methods. (Circulation. 1999;100:1816-1822.)

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HDL cholesterol predicts coronary heart disease mortality in older persons

Cited by 101 publications

References 0 publications

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

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

High interleukin-6 plasma levels are associated with low HDL-C levels in community-dwelling older adults: The InChianti study

Regression of Atherosclerosis Induced by Liver-Directed Gene Transfer of Apolipoprotein A-I in Mice

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