Lipids predicting male and female heart and cardiovascular deaths

[Guest guest]

Hi All,

I was quite surprised that the only indices of lipids for predicting

cardiovascular and heart disease deaths were total cholesterol/HDL ratio in

women and none for men. These were the only multivariate-adjusted levels

and there was a trend for improvements in several.

The paper below is PDF-available.

Cheers, Al.

Am J Cardiol 2003 Jun 1;91(11):1311-5

Sex and time differences in the associations of non-high-density lipoprotein

cholesterol versus other lipid and lipoprotein factors in the prediction of

cardiovascular death (The Rancho Bernardo Study).

von Muhlen D, Langer RD, Barrett-Connor E.

Non-high-density lipoprotein (HDL) cholesterol (total cholesterol [TC] minus

HDL cholesterol) has been suggested as the preferred lipid fraction to

predict cardiovascular disease. We compared the ability of lipids,

lipoproteins, the ratio of total to HDL cholesterol (TC/HDL), and non-HDL

cholesterol to predict fatal coronary heart disease (CHD) and cardiovascular

disease in 1,386 women and 1,094 men (mean age 69 years). After 10 years,

there were more deaths in men (n = 310) than women (n = 268), but the

proportions of deaths attributed to CHD (23% and 25%, respectively) and

cardiovascular disease (48% and 47%) were similar. In men, age-adjusted

values for non-HDL cholesterol, TC/HDL ratio, and triglycerides each

predicted a significantly increased risk of CHD and cardiovascular disease;

none of these associations was independent of pack-years of smoking,

systolic blood pressure, fasting plasma glucose, body mass index, and

physical activity. In women, age-adjusted non-HDL cholesterol levels did not

predict CHD or cardiovascular disease events before or after adjusting for

these covariates and for estrogen replacement therapy. In women, only the

ratio of TC to HDL cholesterol predicted CHD and cardiovascular disease

deaths independent of estrogen use and other risk factors. Observed

associations were sensitive to time, being evident in women at 3 and 5

years, and lost thereafter, but not apparent before 10 years in men. Thus,

non-HDL cholesterol is not superior to individual lipids, lipoproteins, or

their ratios in the prediction of cardiovascular death in older adults.

PMID: 12767422 [PubMed - in process]

Alan Pater, Ph.D.; Faculty of Medicine; Memorial University; St. 's, NL

A1B 3V6 Canada; Tel. No.: (709) 777-6488; Fax No.: (709) 777-7010; email:

apater@...