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Impact of blood lipids on 10-year cardiovascular risk in individuals without dyslipidemia and with low risk factor burden

journal contribution
posted on 2023-05-21, 08:54 authored by Zhen ZhouZhen Zhou, Ong, KL, Whelton, SP, Allison, MA, Curtis, AJ, Blaha, MJ, Monique BreslinMonique Breslin, Tonkin, A, Costan Magnussen, Budoff, M, Mark NelsonMark Nelson

Objective

To determine the association of plasma lipids with the prevalence of subclinical atherosclerosis and 10-year risk of incident cardiovascular (CV) events among healthy individuals without dyslipidemia and with low risk factor burden.

Patients and Methods

The analysis (June 24, 2020, through June 12, 2021) included 1204 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) study who were current nonsmokers and did not have CV disease, hypertension (blood pressure ≥130/80 mm Hg or antihypertensive use), diabetes (fasting glucose ≥126 mg/dL or glucose-lowering medication use), and dyslipidemia (low-density-lipoprotein-cholesterol [LDL-C] ≥160 mg/dL, high-density-lipoprotein-cholesterol [HDL-C] <40 mg/dL, total cholesterol [TC] ≥240 mg/dL, triglycerides [TGs] ≥150 mg/dL, or lipid-lowering medication use) at baseline. Associations of lipids with baseline atherosclerosis (presence of carotid plaque and/or coronary calcification) and incident CV events over 10 years were examined using multivariable relative risk regression and Cox regression, respectively.

Results

At baseline, participants’ median age was 54 (IQR, 49 to 62) years, and 10-year CV risk was 2.7% (IQR, 1.0% to 6.6%); 43.4% had subclinical atherosclerosis. A 1-SD higher LDL-C (23.4 mg/dL), TC (24.7 mg/dL), non–HDL-C (25.3 mg/dL), TC/HDL-C (0.75), and LDL-C/HDL-C (0.66) was associated with a higher prevalence of atherosclerosis of between 6% and 9% (P<.05). For every 1-SD higher LDL-C, non–HDL-C, TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C (0.49), the 10-year incidence of CV events was significantly increased by 40%, 44%, 51%, 49%, and 39%, respectively. For every 1-SD lower HDL-C (13.5 mg/dL), CV risk was increased by 37%. Triglycerides had no association with either outcome.

Conclusion

Except for TGs, all lipid variables were associated with atherosclerosis and future risk of CV disease among persons without dyslipidemia and with low risk factor burden.

History

Publication title

Mayo Clinic Proceedings

Volume

97

Issue

10

Pagination

1883-1893

ISSN

0025-6196

Department/School

Menzies Institute for Medical Research

Publisher

Elsevier Inc.

Place of publication

660 Siebens Bldg Mayo Clinic, Rochester, USA, Mn, 55905

Rights statement

Copyright 2022 Mayo Foundation for Medical Education and Research

Repository Status

  • Restricted

Socio-economic Objectives

Prevention of human diseases and conditions

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