Key result
In adults aged 60 years and older, low HDL-C (<1.1 mmol/L) was associated with a significantly higher risk of all-cause mortality (HR 2.023) and ischemic heart disease (HR 3.2).
Why the study?
Lipid profile components predict cardiovascular disease and mortality, but recent studies have shown mixed results in older populations.
Are lipid profile components associated with all-cause mortality and cardiovascular outcomes in adults aged 60 years and older?
Cohort (n=485)
No
Are lipid profile components associated with all-cause mortality and cardiovascular outcomes in adults aged 60 years and older?
In older adults (≥60 years), low HDL-C is significantly associated with increased all-cause mortality and ischemic heart disease, while high total cholesterol is associated with increased heart failure risk.
Answers are grounded in this paper and cite their sources.
Low HDL-C was associated with higher mortality in adults ≥60 years; hypothesis-generating and should not yet change practice.
Background Lipid profile components play a role in predicting the development of cardiovascular disease and hence mortality, but recent studies have shown mixed results in the older population. The aim of our study was to investigate the association between levels of lipid profile components with all-cause mortality and cardiovascular outcomes among older adults in a primary care setting in Riyadh, Saudi Arabia. Methods A retrospective cohort study was performed among 485 individuals aged 60 years and older who visited the family medicine clinics linked to a tertiary care hospital during the first six months of 2010. The electronic charts of the participants were reviewed up to April 2022 to gather relevant data. Each lipid profile component, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs), was categorized into four quartiles. LDL was calculated using the Friedewald formula. Cardiovascular outcomes included ischemic heart disease (IHD), heart failure (HF), and stroke. Results The mean follow-up period was 12 years. The elderly participants with the lowest HDL-C quartile (<1.1 mmol/L) were at higher risk of all-cause mortality (adjusted hazard ratio of 2.023 (95% CI 1.21-3.38)) and IHD (adjusted hazard ratio 3.2 (95% CI 1.6-6.2)). High TC (≥5.7 mmol/L) was associated with an increased risk of HF (adjusted hazard ratio 2.1 (95% CI 1.1-4.0)). Conclusion In patients aged 60 years and older, low HDL-C (<1.1 mmol/L) was associated with a higher risk for all-cause mortality and IHD, and high TC was associated with an increased risk of having HF. No significant association was found for LDL-C, TC, and TGs with all-cause mortality.
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Almahmoud et al. (2023) conducted a cohort in Older adults in primary care (n=485). Low HDL-C (<1.1 mmol/L) vs. Higher HDL-C (≥1.1 mmol/L) was evaluated on All-cause mortality (HR 2.023, 95% CI 1.21-3.38). In adults aged 60 years and older, low HDL-C (<1.1 mmol/L) was associated with a significantly higher risk of all-cause mortality (HR 2.023) and ischemic heart disease (HR 3.2).
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