Association between lipid level and atherosclerotic CVD in community-dwelling older people: the longitudinal observation of SONIC study

Abstract Background With the aging of the population, it is becoming increasingly important to maintain adequate lipid levels to prevent atherosclerotic cardiovascular diseases (CVD). In older populations, the association between CVD and lipids is controversial. We investigated the association between lipid levels and CVD onset in a community-dwelling older population. Methods The longitudinal study included 1,432 older and oldest-old people. The survey site assessed interviews on medical history and casual blood testing. Participants were divided into two age groups: a 70-yr group and an 80 & 90-yr group, and lipid levels and CVD onset/recurrence were examined in each group. The incidence of cerebral infarction, transient ischemic attack, ischemic heart disease, or bypass/catheter surgery for heart diseases was defined as atherosclerotic CVD. Associations were analyzed using multiple logistic regression to control for sex, age, body mass index, smoking history, drinking history, anti-dyslipidemia medications, hypertension, and diabetes mellitus Results There were 45 onsets of CVD during a three-year follow-up. There was a strong association between high-density lipoprotein (HDL) < 40 mg/dL and CVD (OR = 5.61, 95% CI [2.04–15.44] in the 70-yr group, OR = 3.85, 95% CI [1.29–11.43] in the 80 & 90-yr group). There was a correlation between triglyceride (TG) ≥ 150 mg/dL and CVD in the 80 & 90-yr group (OR = 3.09, 95% CI [1.25–7.62]) but not in the 70-yr group. There was no significant correlation between low-density lipoprotein (LDL) ≥ 140 mg/dL and CVD in either age group. Conclusion A low level of HDL, defined as < 40 mg/dL, and high TG, defined as ≥ 150 mg/dL, were associated with onsets of CVD in community-dwelling older people. On the other hand, high LDL, defined as ≥ 140 mg/dL, indicated no association with CVD in older people. These results suggest that low HDL and high TG may be crucial residual risks for CVD onset in older populations.