{"id":4765,"date":"2018-08-23T14:35:09","date_gmt":"2018-08-23T19:35:09","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=4765"},"modified":"2018-08-28T12:59:51","modified_gmt":"2018-08-28T17:59:51","slug":"high-levels-of-ldl-c-and-non-hdl-c-associated-with-increased-long-term-risk-of-cardiac-death","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=4765","title":{"rendered":"High LDL Levels Can Increase Cardiovascular Mortality Even in Low Risk Population"},"content":{"rendered":"

A recent study published in Circulation<\/a> found that higher levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDLC) increased the relative risk of long-term cardiovascular disease (CVD) mortality by 50% to 80%, in healthy participants that were considered to be at a low 10-year risk prior to the beginning of the study.<\/p>\n

Existing literature has not been conclusive in determining the long-term effects of LDL-C on CVD and coronary heart disease (CHD) mortality in a low-risk cohort, despite the fact that this represents a majority of the population. A recent study was conducted in 36,375 adults who were at a relatively low risk (<7.5%) of atherosclerotic CVD (ASCVD) were followed up for an average period of 26.8 years to observe the effects of LDL-C and non-HDL-C on CVD and CHD mortality.<\/p>\n

The study observations imply further that appropriate LDL-C and non-HDLC thresholds need to be considered when evaluating lipid-lowering medication in individuals that were previously considered low-risk. Participants were grouped into four categories with LDL-C levels measuring 100-129 mg\/dL, 130-159 mg\/dL, 160-189.9 mg\/dL, and \u2265 190 mg\/dL. When compared with participant data who were at an LDL-C level <100 mg\/dL, the hazard ratios (HR) for CVD death were observed to be 1.4 (95% CI, 1.1-1.17), 1.3 (95% CI, 1.1-1.6), 1.9 (95% CI, 1.5-2.4), and 1.7 (95% CI, 1.3-2.3) respectively. The years free of CVD death was reduced by 1.8, 1.1, 4.3, 3.9 years respectively. Further analyses led to the observation of independent association the 160-189.9 mg\/dL and \u2265 190 mg\/dL groups with CVD death HRs of 1.7 (95% CI, 1.4-2.2) and 1.5 (95% CI, 1.2-2.1). For non-HDLC comparisons, participants with <130 mg\/dL were used as reference and compared to participants with 160 to 189 mg\/dL, 190 to 219 mg\/dL, and \u2265220 mg\/dL. Participants with higher levels were associated with significantly higher CVD death, with HRs of 1.3 (95% CI, 1.1-1.6), 1.8 (95% CI, 1.4-2.2), and 1.5 (95% CI, 1.2-2.0) respectively.<\/p>\n

Lower non-HDL-C thresholds were associated with increased CHD mortality rate than their corresponding LDL-C levels, which was recommended as a secondary target for treatment in the 2013 AHA\/ACC guidelines for adult treatment. To sum it up, \u2265 100 mg\/dL of cholesterol was at a \u226530% and participants with \u2265130 mg\/dL was at a \u226550% of relative risk associated with CHD deaths, and non-HDLC \u2265160 mg\/dL was associated with CVD and \u2265130 mg\/dL was associated with CHD mortality.<\/p>\n

Additionally, participants with documented lipid panel measurements between the periods of 1978 and 1998 were included in the study to minimize the effect of lipid-lowering medication which became more prevalent in the early 2000s. The study estimated that the results were more pronounced in participants with a lower risk of 10-year ASCVD (<5%) at the beginning of the study.<\/p>\n

While the study draws scientific evidence to the undesirable effects of increased concentrations of LDL-C and\/or non-HDL-C on risk of CVD in the short-term, the observations did not document factors like lipid-modifying statin therapy intake at baseline (although not very common in low-risk populations, rampant use in recent years), \u00a0participant transition from low to high risk, low to no records of other endpoints due to the participants being low-risk, and race data etc. was not taken into consideration since this is not a population-based study.<\/p>\n

In conclusion, the present study establishes the\u00a0connection between LDL-C and non-HDL-C with CVD and CHD mortality rates. This forms the basis for further research to discover novel outcomes for future cardiovascular studies when evaluating the effects of lipid-modifying lifestyle and treatment in CVD therapy.<\/p>\n

Source:\u00a0https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.118.034273<\/p>\n","protected":false},"excerpt":{"rendered":"

A recent study published in Circulation found that higher levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDLC) increased the relative risk of long-term cardiovascular disease (CVD) mortality by 50% to 80%, in healthy participants that were considered to be at a low 10-year risk prior to the beginning of the study.<\/p>\n","protected":false},"author":8,"featured_media":4767,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"aside","meta":{"footnotes":""},"categories":[12,8,9],"tags":[47],"ppma_author":[1033],"class_list":{"0":"post-4765","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-cardiovascular-prevention","8":"category-news","9":"category-prevention","10":"tag-featured","11":"post_format-post-format-aside","12":"author-sudarshana-datta"},"authors":[{"term_id":1033,"user_id":8,"is_guest":0,"slug":"sudarshana-datta","display_name":"Sudarshana Datta, M.D.","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/b79d07e34756cd9e4c6fe8c77835538219f3ec30c82a6bf8f218760a5f29c84a?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/4765","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4765"}],"version-history":[{"count":6,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/4765\/revisions"}],"predecessor-version":[{"id":4827,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/4765\/revisions\/4827"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/4767"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4765"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4765"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4765"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=4765"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}