Association between low-density lipoprotein cholesterol and cardiovascular mortality in statin non-users: a prospective cohort study in 14.9 million Korean adults

Abstract Background Limited information is available on detailed sex/age-specific associations between low-density lipoprotein cholesterol (LDL-C) and cardiovascular disease (CVD) mortality and ‘the optimal range’ associated with the lowest CVD mortality in the general population. Methods Korean adu...

Full description

Saved in:
Bibliographic Details
Published in:International journal of epidemiology 2022-08, Vol.51 (4), p.1178-1189
Main Authors: Yi, Sang-Wook, An, Sang Joon, Park, Hyung Bok, Yi, Jee-Jeon, Ohrr, Heechoul
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Brain Ischemia
Cardiovascular Disease
Cardiovascular Diseases
Cerebral Hemorrhage
Cholesterol, LDL
Death, Sudden, Cardiac
Female
Heart Failure
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Ischemic Stroke
Male
Myocardial Ischemia
Prospective Studies
Republic of Korea - epidemiology
Risk Factors
Stroke - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Limited information is available on detailed sex/age-specific associations between low-density lipoprotein cholesterol (LDL-C) and cardiovascular disease (CVD) mortality and ‘the optimal range’ associated with the lowest CVD mortality in the general population. Methods Korean adults (N = 14 884 975) who received routine health screenings during 2009–2010 were followed until 2018 for CVD mortality. Results During 8.8 years (mean) of follow-up, 94 344 individuals died from CVD. LDL-C had U-curve associations with mortality from CVD and its subtypes, except haemorrhagic stroke. Optimal range was 90–149 mg/dL for CVD; 70–114 for ischaemic heart disease; 85–129 for ischaemic stroke; ≥85 for subarachnoid haemorrhage; ≥130 for intracerebral haemorrhage; 115–159 for hypertension and heart failure; and 100–144 for sudden cardiac death. Assuming linear associations between 100 and 300 mg/dL, LDL-C was positively associated with CVD mortality [hazard ratio (HR) per 39-mg/dL (1-mmol/L) higher LDL-C = 1.10], largely due to ischaemic heart disease (HR = 1.26), followed by sudden cardiac death (HR = 1.13), ischaemic stroke (HR = 1.11) and heart failure (HR = 1.05). Intracerebral haemorrhage (HR = 0.90), but not subarachnoid haemorrhage, had inverse associations. Women and older adults had weaker positive associations than men and younger adults (Pinteraction 
ISSN:0300-5771
1464-3685
1464-3685
DOI:10.1093/ije/dyac029