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Core 2: Epidemiology and Prevention of CV Disease: Physiology, Pharmacology, and Lifestyle

Abstract 1462: Association of HDL Cholesterol and Apolipoprotein A-1 With Incident CVD Across Levels of LDL Cholesterol in 27,748 Women

Samia Mora, Yadong Cui, Paul M Ridker
Circulation. 2009;120:S507-S508
Samia Mora
Harvard Sch of Medicine, Boston, MA
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Yadong Cui
Merck Rsch Laboratories, North Wales, PA
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Paul M Ridker
Harvard Sch of Medicine, Boston, MA
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Abstract

Background Prior studies have found an inverse association between HDL cholesterol (HDL-C) and apolipoprotein A-1 (apoA-1) with CVD events. Whether this association is consistent in subjects with different levels of LDL cholesterol (LDL-C) is less well studied, particularly in women.

Methods We tested the hypothesis that low HDL-C and apoA-1 are risk factors for CVD across a range of LDL-C levels. Baseline lipids were measured directly, and apoA-1 with an immunoassay, in 27,748 apparently healthy women (mean age 54.7 years) with 11-year follow-up for first CVD events (N=1,017) in the Women’s Health Study.

Results There was a strong inverse association between HDL-C, apoA-1, and risk of CVD. The fully-adjusted hazard ratios (HRs) associated with decreasing quintiles of HDL-C were 1.00, 1.18 (0.90 –1.53), 1.32 (1.01–1.72), 1.50 (1.15–1.96), and 1.66 (1.26 –2.19), Ptrend<0.001. Similarly-adjusted HRs for apoA-1 quintiles HRs were 1.00, 1.11 (0.88 –1.41), 1.08 (0.83–1.39), 1.51 (1.18 –1.92), and 1.42 (1.10 –1.83), Ptrend=0.001. The association of HDL-C with CVD was consistent across levels of LDL-C (Figure⇓), and similarly for apoA-1. Women with HDL-C >90th percentile (>69 mg/dL) had onset of CVD 10 years later than women with HDL-C <10th percentile (<35 mg/dL, P<0.001).

Conclusion In this study of apparently healthy women, HDL-C and apoA-1 were inversely associated with CVD across levels of LDL-C. For women with very high levels of HDL-C, the onset of their first event was delayed by up to 10 years compared with women with low levels of HDL-C.

This research has received full or partial funding support from the American Heart Association, National Center.


Embedded Image
Figure.

CVD incidence rate according to HDL cholesterol and LDL cholesterol clinical cutpoints.

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Circulation
November 3, 2009, Volume 120, Issue Suppl 18
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    Abstract 1462: Association of HDL Cholesterol and Apolipoprotein A-1 With Incident CVD Across Levels of LDL Cholesterol in 27,748 Women
    Samia Mora, Yadong Cui and Paul M Ridker
    Circulation. 2009;120:S507-S508, originally published January 5, 2016

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    Abstract 1462: Association of HDL Cholesterol and Apolipoprotein A-1 With Incident CVD Across Levels of LDL Cholesterol in 27,748 Women
    Samia Mora, Yadong Cui and Paul M Ridker
    Circulation. 2009;120:S507-S508, originally published January 5, 2016
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