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Plasma lipoprotein levels as predictors of cardiovascular death in women.
Arch Intern Med. 1993 Oct 11; 153(19):2209-16.AI

Abstract

BACKGROUND

The association of lipoprotein levels with cardiovascular disease (CVD) is less well understood in women than in men. To better characterize any relationships, associations between CVD death and total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol and triglyceride levels in women were explored using data from female participants in the Lipid Research Clinics' Follow-up Study.

METHODS

Using a sample of 1405 women aged 50 to 69 years from the Lipid Research Clinics' Follow-up Study, age-adjusted CVD death rates and summary relative risk (RR) estimates by categories of lipid and lipoprotein levels were calculated. Multivariate analysis was performed to provide RR estimates adjusted for other CVD risk factors.

RESULTS

Average follow-up was 14 years. High-density lipoprotein and triglyceride levels were strong predictors of CVD death in age-adjusted and multivariate analyses. Low-density lipoprotein and total cholesterol levels were poorer predictors of CVD mortality. After adjustment for other CVD risk factors, HDL levels less than 1.30 mmol/L (50 mg/dL) were strongly associated with cardiovascular mortality (RR = 1.74; 95% confidence interval [CI], 1.10 to 2.75). Triglyceride levels were associated with increased CVD mortality at levels of 2.25 to 4.49 mmol/L (200 to 399 mg/dL) (RR = 1.65; 95% CI, 0.99 to 2.77) and 4.50 mmol/L (400 mg/dL) or greater (RR = 3.44; 95% CI, 1.65 to 7.20). At total cholesterol levels of 5.20 mmol/L (200 mg/dL) or greater and at all levels of LDL and triglycerides, women with HDL levels of less than 1.30 mmol/L (< 50 mg/dL) had CVD death rates that were higher than those of women with HDL levels of 1.30 mmol/L (50 mg/dL) or greater.

CONCLUSIONS

High-density lipoprotein and triglyceride levels are independent lipid predictors of CVD death in women. Cholesterol screening guidelines should be re-evaluated to reflect the importance of HDL and triglyceride levels in determining CVD risk in women.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8215724

Citation

Bass, K M., et al. "Plasma Lipoprotein Levels as Predictors of Cardiovascular Death in Women." Archives of Internal Medicine, vol. 153, no. 19, 1993, pp. 2209-16.
Bass KM, Newschaffer CJ, Klag MJ, et al. Plasma lipoprotein levels as predictors of cardiovascular death in women. Arch Intern Med. 1993;153(19):2209-16.
Bass, K. M., Newschaffer, C. J., Klag, M. J., & Bush, T. L. (1993). Plasma lipoprotein levels as predictors of cardiovascular death in women. Archives of Internal Medicine, 153(19), 2209-16.
Bass KM, et al. Plasma Lipoprotein Levels as Predictors of Cardiovascular Death in Women. Arch Intern Med. 1993 Oct 11;153(19):2209-16. PubMed PMID: 8215724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma lipoprotein levels as predictors of cardiovascular death in women. AU - Bass,K M, AU - Newschaffer,C J, AU - Klag,M J, AU - Bush,T L, PY - 1993/10/11/pubmed PY - 1993/10/11/medline PY - 1993/10/11/entrez SP - 2209 EP - 16 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 153 IS - 19 N2 - BACKGROUND: The association of lipoprotein levels with cardiovascular disease (CVD) is less well understood in women than in men. To better characterize any relationships, associations between CVD death and total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol and triglyceride levels in women were explored using data from female participants in the Lipid Research Clinics' Follow-up Study. METHODS: Using a sample of 1405 women aged 50 to 69 years from the Lipid Research Clinics' Follow-up Study, age-adjusted CVD death rates and summary relative risk (RR) estimates by categories of lipid and lipoprotein levels were calculated. Multivariate analysis was performed to provide RR estimates adjusted for other CVD risk factors. RESULTS: Average follow-up was 14 years. High-density lipoprotein and triglyceride levels were strong predictors of CVD death in age-adjusted and multivariate analyses. Low-density lipoprotein and total cholesterol levels were poorer predictors of CVD mortality. After adjustment for other CVD risk factors, HDL levels less than 1.30 mmol/L (50 mg/dL) were strongly associated with cardiovascular mortality (RR = 1.74; 95% confidence interval [CI], 1.10 to 2.75). Triglyceride levels were associated with increased CVD mortality at levels of 2.25 to 4.49 mmol/L (200 to 399 mg/dL) (RR = 1.65; 95% CI, 0.99 to 2.77) and 4.50 mmol/L (400 mg/dL) or greater (RR = 3.44; 95% CI, 1.65 to 7.20). At total cholesterol levels of 5.20 mmol/L (200 mg/dL) or greater and at all levels of LDL and triglycerides, women with HDL levels of less than 1.30 mmol/L (< 50 mg/dL) had CVD death rates that were higher than those of women with HDL levels of 1.30 mmol/L (50 mg/dL) or greater. CONCLUSIONS: High-density lipoprotein and triglyceride levels are independent lipid predictors of CVD death in women. Cholesterol screening guidelines should be re-evaluated to reflect the importance of HDL and triglyceride levels in determining CVD risk in women. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/8215724/Plasma_lipoprotein_levels_as_predictors_of_cardiovascular_death_in_women_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/153/pg/2209 DB - PRIME DP - Unbound Medicine ER -