Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure
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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/12/3208 |
| _version_ | 1797381856954417152 |
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| author | Carola S. König Amar Mann Rob McFarlane John Marriott Malcolm Price Sudarshan Ramachandran |
| author_facet | Carola S. König Amar Mann Rob McFarlane John Marriott Malcolm Price Sudarshan Ramachandran |
| author_sort | Carola S. König |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T20:58:29Z |
| format | Article |
| id | doaj.art-3550ae4f3e1b4616a5b01b91414b23fa |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-08T20:58:29Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-3550ae4f3e1b4616a5b01b91414b23fa2023-12-22T13:54:58ZengMDPI AGBiomedicines2227-90592023-12-011112320810.3390/biomedicines11123208Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol ExposureCarola S. König0Amar Mann1Rob McFarlane2John Marriott3Malcolm Price4Sudarshan Ramachandran5Department of Mechanical and Aerospace Engineering, Brunel University London, London UB8 3PH, UKInstitute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UKInstitute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UKInstitute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UKInstitute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UKDepartment of Mechanical and Aerospace Engineering, Brunel University London, London UB8 3PH, UKWe 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.https://www.mdpi.com/2227-9059/11/12/3208mathematical modellingresidual cardiovascular riskage and cardiovascular diseaselow density lipoprotein cholesterol exposurenon-LDL-C cardiovascular risk factors |
| spellingShingle | Carola S. König Amar Mann Rob McFarlane John Marriott Malcolm Price Sudarshan Ramachandran Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure Biomedicines mathematical modelling residual cardiovascular risk age and cardiovascular disease low density lipoprotein cholesterol exposure non-LDL-C cardiovascular risk factors |
| title | Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure |
| title_full | Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure |
| title_fullStr | Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure |
| title_full_unstemmed | Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure |
| title_short | Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure |
| title_sort | age and the residual risk of cardiovascular disease following low density lipoprotein cholesterol exposure |
| topic | mathematical modelling residual cardiovascular risk age and cardiovascular disease low density lipoprotein cholesterol exposure non-LDL-C cardiovascular risk factors |
| url | https://www.mdpi.com/2227-9059/11/12/3208 |
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