Differential effects of lipids on the risk of heart failure and coronary heart disease: the Physicians' Health Study. Am Heart J 2008 May;155(5):869-75
Date
04/29/2008Pubmed ID
18440334DOI
10.1016/j.ahj.2007.12.023Scopus ID
2-s2.0-42749088410 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
BACKGROUND: It is understood that coronary heart disease (CHD) is one cause of heart failure, and many risk factors are common to both entities. Hypercholesterolemia, however, being a well-recognized risk factor for CHD, has an unclear association with incident heart failure.
METHODS: We evaluated the relations of total and high-density lipoprotein (HDL) cholesterol to incident heart failure and CHD in 10,813 US male physicians (mean age, 68 years). Total and HDL cholesterol were analyzed both as continuous and as categorical (in quartiles) variables.
RESULTS: There were 222 incident heart failure cases on follow-up (mean, 6 years). In Cox models, after adjusting for traditional coronary risk factors, 1-SD increase in total cholesterol (36.7 mg/dL) and HDL cholesterol (15.3 mg/dL) was not related to incident heart failure with a hazard ratio and 95% CI of 0.91 (0.79-1.05) for total cholesterol and 0.95 (0.82-1.11) for HDL cholesterol. In categorical models, heart failure risk in second, third, and fourth quartiles of total and HDL cholesterol was statistically not different from those in the lowest quartile; hazard ratios with 95% CI were 0.72 (0.49-1.05), 0.76 (0.52-1.11), 0.73 (0.50-1.09) for total cholesterol, and 0.78 (0.53-1.15), 0.66 (0.43-1.00), and 1.03 (0.69-1.54), for HDL cholesterol. Further adjustment for CHD on follow-up or exclusion of individuals with CHD at baseline did not alter the results. In contrast, high total cholesterol and low HDL cholesterol increased the risk of incident CHD (P < .001).
CONCLUSION: In healthy males, total and HDL cholesterol levels were not related to incident heart failure.
Author List
Dhingra R, Sesso HD, Kenchaiah S, Gaziano JMAuthor
Ravi Dhingra MBBS Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedCholesterol
Cholesterol, HDL
Coronary Disease
Health Surveys
Heart Failure
Humans
Hypercholesterolemia
Incidence
Male
Risk Factors
