A longitudinal study in the US revealed that low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol (HDL-C) ≥160 mg/dL were independently associated with a 50% to 80% increased relative risk of cardiovascular disease (CVD) mortality in a low risk cohort with long-term follow-up. The study included 36 375 participants (72% men, median age 42) without a history of CVD or diabetes mellitus and defined as low risk (<7.5%) for 10-year atherosclerotic CVD events at baseline, with a median follow-up of 26.8 years. There were 1086 CVD and 598 coronary heart disease deaths. Compared with LDL-C <100 mg/dL, LDL-C categories 100 to 129, 130 to 159, 160 to 189.9, and ≥190 mg/dL were associated with a significantly higher risk of CVD death, with hazard ratios of 1.4, 1.3, 1.9, and 1.7, and mean reductions in years free of CVD death of 1.8, 1.1, 4.3, and 3.9, respectively. After adjustment for atherosclerotic CVD risk factors, LDL-C categories 160 to 189 mg/dL and ≥190 mg/dL remained independently associated with CVD mortality, with hazard ratios of 1.7 and 1.5, respectively. In multivariable-adjusted models using non–HDL-C <130 mg/dL as the reference, non–HDL-C 160 to 189 mg/dL, 190 to 219 mg/dL, and ≥220 mg/dL were significantly associated with CVD death, with hazard ratios of 1.3, 1.8, and 1.5, respectively. The effectiveness of lowering of LDL-C to reduce CVD risk has been well established. Source: https://www.ahajournals.org/
