Risk of coronary heart disease is associated with triglycerides and high-density lipoprotein cholesterol in women and non–high-density lipoprotein cholesterol in men

Abdel-Maksoud, Madiha; Eckel, Robert H.; Hamman, Richard F.; Hokanson, John E.

doi:10.1016/j.jacl.2012.02.011

Cited by 28 publications

(25 citation statements)

References 32 publications

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“…While the role of serum lipids in cardiometabolic health is well established, showing low HDL and high triglycerides (TGs) to be strong predictors of CVD, 11 their role in reproduction is uncertain. It is also uncertain whether women with no or one lifetime pregnancy have a higher CVD risk to begin with, or whether future pregnancies may reduce the CVD risk.…”

Section: Introductionmentioning

confidence: 99%

Women’s prepregnancy lipid levels and number of children: a Norwegian prospective population-based cohort study

et al. 2018

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ObjectiveTo study prepregnancy serum lipid levels and the association with the number of children.DesignProspective, population-based cohort.SettingLinked data from the Cohort of Norway and the Medical Birth Registry of Norway.Participants2645 women giving birth to their first child during 1994–2003 (488 one-child mothers and 2157 women with ≥2 births) and 1677 nulliparous women.Main outcome measuresORs for no and one lifetime pregnancy (relative to ≥2 pregnancies) obtained by multinomial logistic regression, adjusted for age at examination, education, body mass index (BMI), smoking, time since last meal and oral contraceptive use.ResultsAssessed in quintiles, higher prepregnant triglyceride (TG) and TG to high-density lipoprotein (TG:HDL-c) ratio levels were associated with increased risk of one lifetime pregnancy compared with having ≥2 children. Compared with the highest quintile, women in the lowest quintile of HDL cholesterol levels had an increased risk of one lifetime pregnancy (OR 1.7, 95% CI 1.2 to 2.4), as were women with the highest low-density lipoprotein (LDL) cholesterol, TG and TG:HDL-c ratio quintiles (compared with the lowest) (OR 1.2, 95% CI 0.8 to 1.7; OR 2.2, 95% CI 1.5 to 3.2; and OR 2.2, 95% CI 1.5 to 3.2, respectively). Similar effects were found in women with BMI≥25 and the highest LDL and total cholesterol levels in risk of lifetime nulliparity.ConclusionWomen with unfavourable prepregnant lipid profile had higher risk of having no or only one child. These findings substantiate an association between prepregnant serum lipid levels and number of children. Previously observed associations between low parity and increased cardiovascular mortality may in part be due to pre-existing cardiovascular disease lipid risk factors.

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Section: Introductionmentioning

confidence: 99%

Women’s prepregnancy lipid levels and number of children: a Norwegian prospective population-based cohort study

et al. 2018

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“…In the microscopic model, the collaborative analysis of 101 studies in 2010 found a series of findings consistent with the causal role of TG-mediated pathways in CHD 17. In 2012, a study suggested that the risk of CHD associated with low HDL-C in women was greater than twofold to fourfold elevated depending on TG levels and elevated TG and low HDL-C with a substantially low CHD risk 32. In addition, a study has found that isolated low HDL-C or high TG levels are independently associated with CHD risk in men 33.…”

Section: Discussionmentioning

confidence: 99%

Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study

Xia

Wang

et al. 2019

BMJ Open

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ObjectivesThe aim of this study was to evaluate the relationship between mean arterial pressure (MAP) and coronary heart disease (CHD) in Chinese rural population. In addition, we hypothesised that this relationship might be mediated by some degree of serum lipids.DesignThis is a cross-sectional study.SettingThe participants were from the Henan Rural Cohort Study, initiated in five rural areas (Tongxu county of Kaifeng city, Yima county of Sanmenxia city, Suiping county of Zhumadian city, Xinxiang county of Xinxiang city and Yuzhou county of Xuchang city) in Henan Province, China, during July 2015 and September 2017.ParticipantsThe study included 39 020 subjects aged 18–79 years as current research population.Outcome measuresSystolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using an electronic sphygmomanometer. MAP was calculated by one-third SBP plus two-thirds DBP. The study used restricted cubic splines and logistic regression models to evaluate the ORs and 95% CIs. Mediation analysis using bootstrap was performed to examine the contribution of serum lipids to MAP-related CHD.ResultsThe adjusted OR (95% CI) for the highest MAP quartile with the risk of CHD was 1.45 (1.24 to 1.69) compared with the lowest quartile. Simultaneously, each 1-SD increment in MAP was significantly associated with a 12% increased risk of CHD. A linear dose–response relationship between MAP and CHD was found (p value for non-linear=0.1169) in the fully adjusted model. We further reported that 36.07% of proportion explained risk of CHD was mediated through serum lipids.ConclusionsIncreased MAP was a significant marker of CHD in Chinese rural population. Meanwhile, the relationship was mediated by some degree of serum lipids, and triglyceride was the strongest mediator.Trial registration numberHenan Rural Cohort study has been registered at Chinese Clinical Trial Register (ChiCTR-OOC-15006699) and the stage it relates to is Post-results.

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“…Women who were Current or Former Tobacco Users were less likely to meet the target goals for Triglycerides and more likely to meet target goals for Cholesterol and Non-HDL Cholesterol. Triglycerides are a greater risk factor for CVD for women (Abdel-Maksoud et al, 2012) and more difficult to change with lifestyle modification in women (Wood et al, 1991). Conversely, Non-HDL Cholesterol is more strongly associated with CVD for men than women (Abdel-Madsoud et al, 2012) suggesting the need for increased attention to Non-HDL Cholesterol in men and triglycerides in women who are or were tobacco users.…”

Section: Discussionmentioning

confidence: 99%

“…Triglycerides are a greater risk factor for CVD for women (Abdel-Maksoud et al, 2012) and more difficult to change with lifestyle modification in women (Wood et al, 1991). Conversely, Non-HDL Cholesterol is more strongly associated with CVD for men than women (Abdel-Madsoud et al, 2012) suggesting the need for increased attention to Non-HDL Cholesterol in men and triglycerides in women who are or were tobacco users. As a note, the majority of the participants in CR were taking lipid lowering agents and these percentages did not differ by gender (male 93.7% versus female 91.1%, p=0.12) or tobacco use status (Current Tobacco Users 94.5%, Former Tobacco Users 92.1%, Never Tobacco Users 94.0%, p=0.44).…”

Section: Discussionmentioning

confidence: 99%

The association of tobacco use and gender to cardiac rehabilitation outcomes: a preliminary investigation

Weinberger

Mazure

McKee

et al. 2013

Journal of Substance Use

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Introduction Cardiac rehabilitation (CR) outcomes are measured in terms of cardiovascular disease (CVD) risk factor reductions, and these predict long-term cardiac status. This report examines whether reported tobacco use has differential effects on successful cardiovascular risk factor modification, especially for women who have greater smoking-related CVD consequences than men. Methods A retrospective cohort analysis was conducted on 1138 adults (74% male) with diagnosed CVD who participated in ≥7 weeks of a comprehensive CR program. Eleven CVD risk factors were assessed at CR entry and completion. Tobacco use was assessed by self-report at CR entry. The primary outcomes were attainment of goal levels for each risk factor. Results Fewer current and former tobacco users reached the preset goal for Maximal Exercise Capacity. Fewer women than men reached the preset goal for HDL. Women who were current or former tobacco users were less likely to meet the target goals for Triglycerides and more likely to meet target goals for Total Cholesterol and Non-HDL Cholesterol. Conclusions This preliminary study suggests the importance of identifying the effect of tobacco use and gender on CR outcomes and the need to evaluate modification of key cardiovascular risk factors for subgroups of cardiac patients.

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Risk of coronary heart disease is associated with triglycerides and high-density lipoprotein cholesterol in women and non–high-density lipoprotein cholesterol in men

Cited by 28 publications

References 32 publications

Women’s prepregnancy lipid levels and number of children: a Norwegian prospective population-based cohort study

Women’s prepregnancy lipid levels and number of children: a Norwegian prospective population-based cohort study

Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study

The association of tobacco use and gender to cardiac rehabilitation outcomes: a preliminary investigation

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