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Atherosclerosis. 2015 Mar;239(1):137-42. doi: 10.1016/j.atherosclerosis.2015.01.002. Epub 2015 Jan 14.

Low-density lipoprotein cholesterol was inversely associated with 3-year all-cause mortality among Chinese oldest old: data from the Chinese Longitudinal Healthy Longevity Survey.

Author information

1
Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China.
2
Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore.
3
Vanderbilt Institute for Global Health, Division of Epidemiology, Department of Medicine, Vanderbilt University, Nashville, TN, USA.
4
Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
5
Department of Sociology and Anthropology, Department of Human Development and Family Studies, University of Rhode Island, Kingston, RI, USA.
6
Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: shixm@chinacdc.cn.
7
Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore; Center for Clinical Health Policy Research and Department of Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: david.matchar@duke-nus.edu.sg.
8
Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA; Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China. Electronic address: zengyi68@gmail.com.

Abstract

OBJECTIVE:

Low-density lipoprotein cholesterol (LDL-C) is a risk factor for survival in middle-aged individuals, but conflicting evidence exists on the relationship between LDL-C and all-cause mortality among the elderly. The goal of this study was to assess the relationship between LDL-C and all-cause mortality among Chinese oldest old (aged 80 and older) in a prospective cohort study.

METHODS:

LDL-C concentration was measured at baseline and all-cause mortality was calculated over a 3-year period. Multiple statistical models were used to adjust for demographic and biological covariates.

RESULTS:

During three years of follow-up, 447 of 935 participants died, and the overall all-cause mortality was 49.8%. Each 1 mmol/L increase of LDL-C concentration corresponded to a 19% decrease in 3-year all-cause mortality (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.71-0.92). The crude HR for abnormally higher LDL-C concentration (≥3.37 mmol/L) was 0.65 (0.41-1.03); and the adjusted HR was statistically significant around 0.60 (0.37-0.95) when adjusted for different sets of confounding factors. Results of sensitivity analysis also showed a significant association between higher LDL-C and lower mortality risk.

CONCLUSIONS:

Among the Chinese oldest old, higher LDL-C level was associated with lower risk of all-cause mortality. Our findings suggested the necessity of re-evaluating the optimal level of LDL-C among the oldest old.

KEYWORDS:

China; Epidemiology; LDL-C; Mortality; Oldest old

[Indexed for MEDLINE]
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