Combined Association of Lipids and Blood Pressure in Relation to Incident Cardiovascular Disease in the Elderly: The Cardiovascular Health Study
Key result
Combined BP ≥160/100 mm Hg and LDL-C ≥160 mg/dl or HDL-C <40 mg/dl was associated with increased risk of incident CVD compared to optimal levels (HR 2.1; P<0.01).
Why the study?
Does the combination of elevated blood pressure and dyslipidemia increase the risk of incident cardiovascular disease in the elderly?
Population
4,311 participants aged 65-98 with no prior cardiovascular disease from the Cardiovascular Health Study
Comparison
Combined categories of blood pressure and lipid… vs Reference group with optimal blood pressure and…
Design
Cohort
Follow-up
15 years
Authors
Discussion
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Implication
May guide combined risk stratification in elderly; hypothesis-generating for joint BP-lipid interventions.
Study Design
Type
Cohort (n=4,311)
Structured PICO
Does the combination of elevated blood pressure and dyslipidemia increase the risk of incident cardiovascular disease in the elderly?
P
Population
4,311 older adults aged 65-98 (61.2% female) with no prior cardiovascular disease, followed for 15 years.
E
Exposure
Combined categories of blood pressure and lipid levels (LDL, HDL, non-HDL)
C
Comparator
Reference group with optimal blood pressure (<120/80 mm Hg) and optimal lipids (LDL-C <100 mg/dl or HDL-C >60 mg/dl)
O
Outcome
Incident cardiovascular disease (composite of coronary heart disease [angina, myocardial infarction, angioplasty, coronary bypass surgery, or CHD death], stroke, claudication, and CVD death) over 15 yearscomposite
Main Result
Hazard Ratio: 2.1
Absolute Event Rate: 94.8% vs 38.4%
p-value: p=< 0.01
Elevated blood pressure increases CVD risk across all lipid levels in the elderly, with high LDL-C adding risk mainly at lower BP levels and low HDL-C adding risk even in those with hypertension.
Cite This Study
Wong et al. (2009) conducted a cohort in Incident Cardiovascular Disease (n=4,311). Combined blood pressure and lipid levels vs. Optimal blood pressure (<120/80 mm Hg) and lipid levels (LDL-C <100 mg/dl or HDL-C >60 mg/dl) was evaluated on Incident CVD (including CHD, stroke, claudication, and CVD death) (HR 2.1, p=< 0.01). Combined BP ≥160/100 mm Hg and LDL-C ≥160 mg/dl or HDL-C <40 mg/dl was associated with increased risk of incident CVD compared to optimal levels (HR 2.1; P<0.01).