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Combined association of lipids and blood pressure in relation to incident cardiovascular disease in the elderly: the cardiovascular health study.
Tuesday,2012-11-06 12:18 America/Los_Angeles — eenright
| Title | Combined association of lipids and blood pressure in relation to incident cardiovascular disease in the elderly: the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2010 |
| Authors | Wong, ND, Lopez, VA, Roberts, CS, Solomon, HA, Burke, GL, Kuller, L, Tracy, R, Yanez, D, Psaty, BM |
| Journal | Am J Hypertens |
| Volume | 23 |
| Issue | 2 |
| Pagination | 161-7 |
| Date Published | 2010 Feb |
| ISSN | 1941-7225 |
| Keywords | Age Factors, Aged, Aged, 80 and over, Blood Pressure, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Diabetes Mellitus, Female, Health Surveys, Humans, Likelihood Functions, Lipids, Male, Proportional Hazards Models, Sex Factors, Smoking, Socioeconomic Factors, United States |
| Abstract | <p><b>BACKGROUND: </b>Hypertension and dyslipidemia are highly prevalent in the elderly. We studied the combined impact of both conditions on cardiovascular disease (CVD) events.</p><p><b>METHODS: </b>We studied 4,311 participants aged 65-98 (61.2% female) from the Cardiovascular Health Study (CHS), a longitudinal epidemiologic study, with no prior CVD. We evaluated the relation of low-density lipoprotein (LDL), high-density lipoprotein (HDL), or non-HDL-cholesterol combined with blood pressure (BP) categories to incident CVD-including coronary heart disease (CHD) (angina, myocardial infarction (MI), angioplasty, coronary bypass surgery, or CHD death), stroke, claudication, and CVD death over 15 years.</p><p><b>RESULTS: </b>CVD incidence (per 1,000 person years) ranged from 38.4 when BP <120/80 mm Hg and LDL-C <100 mg/dl to 94.8 when BP >or=160/100 mm Hg and LDL-C >or=160 mg/dl, and from 28.9 when BP <120/80 mm Hg and HDL >60 mg/dl to 87.1 for a BP >or=160/100 and HDL-C <40 mg/dl. Compared with those with BP <120/80 mm Hg with either LDL-C <100 mg/dl or HDL-C >60 mg/dl, hazard ratios (HRs) for CVD events were 2.1 when BP >or=160/100 mm Hg and LDL-C >or=160 mg/dl and 2.1 when BP >or=160/100 and HDL-C <40 mg/dl (all P < 0.01), with similar results for non-HDL-C. Elevated BP was associated with increased risk across all lipid levels. Increased LDL-C added risk mainly when BP <140/90 mm Hg, but lower HDL-C also predicted CVD in those with higher BP.</p><p><b>CONCLUSION: </b>Increased BP confers increased risks for CVD in elderly persons across all lipid levels. Although increased LDL-C added risk mainly when BP <140/90 mm Hg, low HDL-C added risk also in those with hypertension. These results document the importance of combined hypertension and dyslipidemia.</p> |
| DOI | 10.1038/ajh.2009.216 |
| Alternate Journal | Am. J. Hypertens. |
| PubMed ID | 19927131 |
| PubMed Central ID | PMC3803135 |
| Grant List | N01-HC-85085 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States |