Abstract 13370: Longitudinal Changes in High-Density Lipoprotein Cholesterol and Cardiovascular Risk in Older Adults
While low HDL cholesterol is associated with increased CVD morbidity and mortality, there are limited data evaluating the association of longitudinal change in HDL with CVD risk, particularly in older populations. We examined CVD risk associated with changes in HDL using data from the Framingham Heart Study (Offspring). We obtained data from up to 7 study exams on 4989 subjects between the ages of 13-62 yrs at baseline. The cohort criteria for the current analysis were: ≥50 yrs of age, at least 2 consecutive HDL measurements, and no prior CVD history. A CVD event was defined as the first occurrence of any of the following: CHD, cerebrovascular event, peripheral artery disease, and heart failure. Change in HDL was evaluated as between-exam (∼3.5 yrs) percentage change in HDL, categorized as ≥5% decrease, <5% increase or decrease (stable), and ≥5% increase. Crude and adjusted sex-specific time-dependent Cox hazards regression models were developed to quantify the relationship between change in HDL and CVD events. Mean baseline age of the cohort was 53 yrs. The distribution of the main exposure at baseline was: HDL ≥5% decrease (men N=471, women N=549); HDL stable (men N=304, women N=352), and HDL ≥5% increase (men N=518, women N=521). There were 233 and 111 CVD events among men and women, respectively. In both sexes, the most common event was CHD. Although there was evidence of a dose response relationship, change in HDL was not statistically significantly associated with CVD incidence in men. There were non-significant increases in CVD risk with change in HDL of ≥5% among women. In-depth analyses of these data do not support a profound influence of “short-term” changes in HDL levels on CVD risk in aging men and women.
- © 2011 by American Heart Association, Inc.