Non-HDL Cholesterol Predicts Future CVD Risk

Non-HDL cholesterol concentrations are strongly associated with long-term risk for cardiovascular events, according to the results of a recent study.

The relevance of blood lipid concentrations and lipid-lowering therapy for long-term cardiovascular disease and cardiovascular outcomes is unclear, according to the researchers. For this reason, they created a simple tool to estimate the probabilities of a cardiovascular disease by age 75 years. The tool used age, sex, and risk factors, and modelled risk reduction assuming a 50% reduction of non-HDL cholesterol.

They used data from 19 countries involving 398,846 individuals without prevalent cardiovascular disease at baseline and available cardiovascular outcome data. Of these, 199 415 individuals were included in the derivation cohort and 199 431 in the validation cohort. During a maximum follow-up of 43.6 years, 54,542 cardiovascular events occurred. Using incidence curve analyses, they found that increasing non-HDL cholesterol categories were associated with progressively higher 30-year cardiovascular disease event-rates, and multivariable adjusted Cox models revealed an increase in the association between non-HDL cholesterol concentration and cardiovascular disease.

Using their tool, they found that a 50% reduction of non-HDL cholesterol concentrations was associated with a reduction in the risk of cardiovascular disease which was greater the earlier the reduction occurred in life.

“Non-HDL cholesterol concentrations in blood are strongly associated with long-term risk of atherosclerotic cardiovascular disease,” they concluded.

“These data could be useful for physician–patient communication about primary prevention strategies.”

—Michael Potts

Reference:

Brunner FJ, Waldeyer C, Ojeda F, et al. Application of non-HDL cholesterol for population-based cardiovascular risk stratification: results from the multinational cardiovascular risk consortium [published online December 3, 2019]. Lancet. https://doi.org/10.1016/S0140-6736(19)32519-X.