Long-term moderately elevated LDL-cholesterol and blood pressure and risk of coronary heart disease.
Pubmed ID: 30059527
Pubmed Central ID: PMC6066205
Journal: PloS one
Publication Date: July 30, 2018
MeSH Terms: Humans, Male, Female, Risk Factors, Middle Aged, Coronary Disease, Blood Pressure, Follow-Up Studies, Time Factors, Cholesterol, LDL
Authors: Danaei G, Ueda P, Gulayin P
Cite As: Ueda P, Gulayin P, Danaei G. Long-term moderately elevated LDL-cholesterol and blood pressure and risk of coronary heart disease. PLoS One 2018 Jul 30;13(7):e0200017. doi: 10.1371/journal.pone.0200017. eCollection 2018.
Studies:
Abstract
BACKGROUND: Harmful effects of long-term exposure to moderately elevated low-density lipoprotein (LDL)-cholesterol and blood pressure on coronary heart disease (CHD) have not been rigorously examined. We estimated the risk of CHD under long-term exposure to moderately elevated LDL-cholesterol and blood pressure compared with the risk under shorter exposures to higher levels of the same risk factors. METHODS: Observational study using data from 2,714 adults in Framingham Offspring Study who were free of existing cardiovascular disease and aged <70 years at baseline (1987-1991). We used the parametric g-formula to estimate 16-year CHD risk under different levels and durations of exposure to LDL-cholesterol (low: <130 mg/dL, moderate: 130 to <160 mg/dL, high 160 to <190 mg/dL, and very high: ≥190 mg/dL) and systolic blood pressure (low: <120 mmHg, prehypertension: 120 to <140 mmHg, stage 1 hypertension: 140 to <160 mmHg, and stage 2 hypertension: ≥160 mmHg). RESULTS: The estimated 16-year CHD risk under exposure to low LDL was 8.2% (95% CI = 7.0-9.6). The 16-year CHD risk under exposure to moderate LDL was 8.9% (7.8-10.1) which was similar to CHD risk under 8 years of low LDL followed by 8 years of high LDL at 9.0% (7.7-10.3); and 12 years of low LDL followed by 4 years of very high LDL at 8.8% (7.6-10.1). The results for blood pressure were similar. CONCLUSIONS: Long-term exposure to moderate levels of LDL-cholesterol and blood pressure had a similar impact on CHD risk as shorter exposures to levels considered 'high' per clinical guidelines.