Circulation, Vol 86, 858-869, Copyright © 1992 by American Heart Association
WH Ettinger, PW Wahl, LH Kuller, TL Bush, RP Tracy, TA Manolio, NO Borhani, ND Wong and DH O'Leary
BACKGROUND. Cardiovascular disease is the leading cause of death and
disability in older people. There is little information about the
distributions of risk factors in older populations. This article describes
the distribution and correlates of lipoprotein lipids in people greater
than or equal to 65 years old. METHODS AND RESULTS. Lipoprotein lipid
concentrations were measured in 2,106 men (M) and 2,732 women (F) who were
participants in the Cardiovascular Health Study, a population-based
epidemiological study. Distributions of lipids by age and sex and bivariate
and multivariate relations among lipids and other variables were determined
in cross-sectional analyses. Mean concentrations of lipids were
cholesterol: M, 5.20 +/- 0.93 mmol/l (201 +/- 36 mg/dl) and F, 5.81 +/-
0.98 mmol/l (225 +/- 38 mg/dl); triglyceride (TG): M, 1.58 +/- 0.85 mmol/l
(140 +/- 75 mg/dl) and F, 1.57 +/- 0.78 mmol/l (139 +/- 69 mg/dl); high
density lipoprotein cholesterol (HDL-C): M, 1.23 +/- 0.33 mmol/l (48 +/- 16
mg/dl), and F, 1.53 +/- 0.41 mmol/l (59 +/- 16 mg/dl); low density
lipoprotein cholesterol (LDL-C): M, 3.27 +/- 0.85 mmol/l (127 +/- 33 mg/dl)
and F, 3.57 +/- 0.93 mmol/l (138 +/- 36 mg/dl). The total cholesterol to
HDL-C ratios were M, 4.49 +/- 1.29 and F, 4.05 +/- 1.22. TG, total
cholesterol, and LDL-C concentrations were lower with increasing age, the
last more evident in men than in women. TG concentration was positively
associated with obesity (in women), central fat patterning, glucose
intolerance, use of beta-blockers (in men), and use of estrogens (in women)
and negatively associated with age, renal function, alcohol use, and
socioeconomic status. In general, HDL-C had opposite relations with these
variables, except that estrogen use was associated with higher HDL-C
concentrations. LDL-C concentration was associated with far fewer variables
than the other lipids but was negatively associated with age in men and
women and positively correlated with obesity and central fat patterning and
negatively correlated with renal function and estrogen use in women. There
were no differences in total cholesterol and LDL-C concentrations among
participants with and without prevalent coronary heart disease and stroke,
but TG concentration was higher and HDL-C lower in men with both coronary
heart disease and stroke and in women with coronary heart disease.
CONCLUSIONS. Cholesterol and cholesterol/HDL-C ratio were lower and HDL-C
higher than previously reported values in older people, suggesting that
lipid risk profiles may be improving in older Americans. TG and HDL-C
concentrations, and to a lesser extent LDL-C, were associated with
potentially important modifiable factors such as obesity, glucose
intolerance, renal function, and medication use.
ARTICLES
Lipoprotein lipids in older people. Results from the Cardiovascular Health Study. The CHS Collaborative Research Group
Department of Internal Medicine, Wake Forest University, Winston-Salem, NC.
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