Lisandro D Colantonio1, Vera Bittner1, Kristi Reynolds1, Emily B Levitan1, Robert S Rosenson1, Maciej Banach1, Shia T Kent1, Stephen F Derose1, Hui Zhou1, Monika M Safford1, Paul Muntner2. 1. From Department of Epidemiology (L.D.C., E.B.L., S.T.K., P.M.), Department of Medicine, Division of Cardiovascular Disease (V.B.), and Department of Medicine, Division of Preventive Medicine (M.M.S.), University of Alabama at Birmingham; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (K.R., S.F.D., Z.H.); Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (R.S.R.); and Department of Hypertension, Medical University of Lodz, Poland (M.B.). 2. From Department of Epidemiology (L.D.C., E.B.L., S.T.K., P.M.), Department of Medicine, Division of Cardiovascular Disease (V.B.), and Department of Medicine, Division of Preventive Medicine (M.M.S.), University of Alabama at Birmingham; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (K.R., S.F.D., Z.H.); Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (R.S.R.); and Department of Hypertension, Medical University of Lodz, Poland (M.B.). pmuntner@uab.edu.
Abstract
BACKGROUND: The use of statins increased among US adults with high coronary heart disease (CHD) risk after publication of the 2001 cholesterol treatment guidelines. METHODS AND RESULTS: We analyzed the association between lipids and CHD among 9578 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants and 346,595 Kaiser Permanente Southern California (KPSC) members with baseline lipid measurements in 2003 to 2007. We performed the same analyses among 14,590 Atherosclerosis Risk In Communities (ARIC) study participants with lipid measurements in 1987 to 1989. Analyses were restricted to blacks and whites 45 to 64 years of age without CHD who were not taking statins at baseline. Total cholesterol, high-density lipoprotein cholesterol, and triglycerides were measured at baseline. Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and ratios of total to high-density lipoprotein cholesterol and triglycerides to high-density lipoprotein cholesterol were calculated. The prevalence of diabetes mellitus, history of stroke, and antihypertensive medication use increased at higher low-density lipoprotein cholesterol in ARIC but not in REGARDS or KPSC. Over 8.9 years of follow-up, 225 CHD events occurred in REGARDS, 6547 events in KPSC, and 583 events in ARIC. After multivariable adjustment, less favorable lipid levels were associated with higher hazard ratios for CHD in ARIC. These associations were attenuated in REGARDS and KPSC. For example, the hazard ratio associated with the highest versus lowest quartile of low-density lipoprotein cholesterol (≥ 146 versus ≤ 102 mg/dL) was 1.89 (95% confidence interval, 1.42-2.51) in ARIC, 1.25 (95% confidence interval, 0.81-1.92) in REGARDS, and 1.49 (95% confidence interval, 1.38-1.61) in KPSC. CONCLUSION: The association between lipids and CHD in contemporary studies may be attenuated by the preferential use of statins by high-risk individuals.
BACKGROUND: The use of statins increased among US adults with high coronary heart disease (CHD) risk after publication of the 2001 cholesterol treatment guidelines. METHODS AND RESULTS: We analyzed the association between lipids and CHD among 9578 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants and 346,595 Kaiser Permanente Southern California (KPSC) members with baseline lipid measurements in 2003 to 2007. We performed the same analyses among 14,590 Atherosclerosis Risk In Communities (ARIC) study participants with lipid measurements in 1987 to 1989. Analyses were restricted to blacks and whites 45 to 64 years of age without CHD who were not taking statins at baseline. Total cholesterol, high-density lipoprotein cholesterol, and triglycerides were measured at baseline. Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and ratios of total to high-density lipoprotein cholesterol and triglycerides to high-density lipoprotein cholesterol were calculated. The prevalence of diabetes mellitus, history of stroke, and antihypertensive medication use increased at higher low-density lipoprotein cholesterol in ARIC but not in REGARDS or KPSC. Over 8.9 years of follow-up, 225 CHD events occurred in REGARDS, 6547 events in KPSC, and 583 events in ARIC. After multivariable adjustment, less favorable lipid levels were associated with higher hazard ratios for CHD in ARIC. These associations were attenuated in REGARDS and KPSC. For example, the hazard ratio associated with the highest versus lowest quartile of low-density lipoprotein cholesterol (≥ 146 versus ≤ 102 mg/dL) was 1.89 (95% confidence interval, 1.42-2.51) in ARIC, 1.25 (95% confidence interval, 0.81-1.92) in REGARDS, and 1.49 (95% confidence interval, 1.38-1.61) in KPSC. CONCLUSION: The association between lipids and CHD in contemporary studies may be attenuated by the preferential use of statins by high-risk individuals.
Authors: Virginia J Howard; Mary Cushman; Leavonne Pulley; Camilo R Gomez; Rodney C Go; Ronald J Prineas; Andra Graham; Claudia S Moy; George Howard Journal: Neuroepidemiology Date: 2005-06-29 Impact factor: 3.282
Authors: Jordan Fulcher; Rachel O'Connell; Merryn Voysey; Jonathan Emberson; Lisa Blackwell; Borislava Mihaylova; John Simes; Rory Collins; Adrienne Kirby; Helen Colhoun; Eugene Braunwald; John La Rosa; T R Pedersen; Andrew Tonkin; Barry Davis; Peter Sleight; Maria Grazia Franzosi; Colin Baigent; Anthony Keech Journal: Lancet Date: 2015-01-09 Impact factor: 79.321
Authors: Guruprasad Manjunath; Hocine Tighiouart; Hassan Ibrahim; Bonnie MacLeod; Deeb N Salem; John L Griffith; Josef Coresh; Andrew S Levey; Mark J Sarnak Journal: J Am Coll Cardiol Date: 2003-01-01 Impact factor: 24.094
Authors: Jonathan A C Sterne; Ian R White; John B Carlin; Michael Spratt; Patrick Royston; Michael G Kenward; Angela M Wood; James R Carpenter Journal: BMJ Date: 2009-06-29
Authors: Paul Muntner; Emily B Levitan; Todd M Brown; Pradeep Sharma; Hong Zhao; Vera Bittner; Stephen Glasser; Meredith Kilgore; Huifeng Yun; J Michael Woolley; Michael E Farkouh; Robert S Rosenson Journal: Am J Cardiol Date: 2013-05-29 Impact factor: 2.778
Authors: J Shepherd; S M Cobbe; I Ford; C G Isles; A R Lorimer; P W MacFarlane; J H McKillop; C J Packard Journal: N Engl J Med Date: 1995-11-16 Impact factor: 91.245
Authors: Maciej Banach; Piotr Jankowski; Jacek Jóźwiak; Barbara Cybulska; Adam Windak; Tomasz Guzik; Artur Mamcarz; Marlena Broncel; Tomasz Tomasik; Jacek Rysz; Agnieszka Jankowska-Zduńczyk; Piotr Hoffman; Agnieszka Mastalerz-Migas Journal: Arch Med Sci Date: 2016-12-19 Impact factor: 3.318
Authors: Arrigo F G Cicero; Alessandro Colletti; Gani Bajraktari; Olivier Descamps; Dragan M Djuric; Marat Ezhov; Zlatko Fras; Niki Katsiki; Michel Langlois; Gustavs Latkovskis; Demosthenes B Panagiotakos; Gyorgy Paragh; Dimitri P Mikhailidis; Olena Mitchenko; Bernhard Paulweber; Daniel Pella; Christos Pitsavos; Željko Reiner; Kausik K Ray; Manfredi Rizzo; Amirhossein Sahebkar; Maria-Corina Serban; Laurence S Sperling; Peter P Toth; Dragos Vinereanu; Michal Vrablík; Nathan D Wong; Maciej Banach Journal: Arch Med Sci Date: 2017-08-04 Impact factor: 3.318
Authors: Maciej Banach; Paweł Burchardt; Krzysztof Chlebus; Piotr Dobrowolski; Dariusz Dudek; Krzysztof Dyrbuś; Mariusz Gąsior; Piotr Jankowski; Jacek Jóźwiak; Longina Kłosiewicz-Latoszek; Irina Kowalska; Maciej Małecki; Aleksander Prejbisz; Michał Rakowski; Jacek Rysz; Bogdan Solnica; Dariusz Sitkiewicz; Grażyna Sygitowicz; Grażyna Sypniewska; Tomasz Tomasik; Adam Windak; Dorota Zozulińska-Ziółkiewicz; Barbara Cybulska Journal: Arch Med Sci Date: 2021-11-08 Impact factor: 3.318
Authors: Shia T Kent; Robert S Rosenson; Christy L Avery; Yii-Der I Chen; Adolfo Correa; Steven R Cummings; L Adrienne Cupples; Mary Cushman; Daniel S Evans; Vilmundur Gudnason; Tamara B Harris; George Howard; Marguerite R Irvin; Suzanne E Judd; J Wouter Jukema; Leslie Lange; Emily B Levitan; Xiaohui Li; Yongmei Liu; Wendy S Post; Iris Postmus; Bruce M Psaty; Jerome I Rotter; Monika M Safford; Colleen M Sitlani; Albert V Smith; James D Stewart; Stella Trompet; Fangui Sun; Ramachandran S Vasan; J Michael Woolley; Eric A Whitsel; Kerri L Wiggins; James G Wilson; Paul Muntner Journal: Circ Cardiovasc Genet Date: 2017-08