Age and the residual risk of cardiovascular disease following low density lipoprotein-cholesterol exposure
Abstract
We believe that there is sufficient evidence from basic science, longitudinal cohort studies and randomised controlled trials which validates the low-density lipoprotein cholesterol (LDL-C) or lipid hypothesis. It is important that we can communicate details of the cardiovascular disease (CVD) risk reduction that the average patient could expect depending on the scale of LDL-C decrease following lipid lowering therapy. It is also essential that residual risk (ResR) of CVD be highlighted. To achieve this aim by using existing trial evidence, we developed mathematical models initially for relative risk reduction (RRR) and absolute risk (AR) reduction and then showed that despite optimising LDL-C levels, a considerable degree of ResR remains that is dependent on AR. Age is significantly associated with AR (odds ratio: 1.02, 95% confidence intervals: 1.01-1.04) as was previously demonstrated by analysing the Whickham study cohort using a logistic regression model (age remaining significant even when all the other significant risk factors such as sex, smoking, systolic blood pressure, diabetes and family history were included in the regression model). A discussion of a paper by Ference et al. provided detailed evidence of the relationship between age and AR, based on lifetime LDL-C exposure. Finally, we discussed non-traditional CVD risk factors that may contribute to ResR based on randomised controlled trials investigating drugs improving inflammation, thrombosis, metabolic and endothelial status.
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Date
2023-12-02
Type
Article
Subject
Cardiology, Oncology. Pathology., Vascular diseases
Collections
Citation
König CS, Mann A, McFarlane R, Marriott J, Price M, Ramachandran S. Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure. Biomedicines. 2023 Dec 2;11(12):3208. doi: 10.3390/biomedicines11123208.
Journal / Source Title
Biomedicines
DOI
10.3390/biomedicines11123208
PMID
38137429
Publisher
MDPI
Publisher’s URL
http://www.mdpi.com/journal/biomedicines