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Cholesterol and Coronary Artery Disease: Age as an Effect Modifier.

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
H. William Gruchow, Professor (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/

Abstract: An elevation of serum cholesterol has been one of the more frequently cited risk factors for coronary heart disease, found in both case-control and cohort studies. As a result, this country has undertaken massive screening of adults older than 20 years of age in an attempt to identify those persons with cholesterol levels greater than 200 mg/dl, and follow up with an active approach for intervention. The suggested cutpoints for borderline (200-240 mg/dl), and definite (=240 mg/dl) hypercholesterolemia have been applied to all age groups despite suggestions of a diminution of risk conferred by cholesterol in the elderly. This study of 2544 white men undergoing coronary angiography shows that for all men, aged 25-84 years, plasma cholesterol levels were associated with an increase in coronary artery occlusion (rs = 0.15, p < 0.01). However, when stratified by age, this association held only for the younger men, the association diminishing to near zero in the oldest age group. The negative interaction between cholesterol levels and age in predicting coronary artery disease proved highly significant (p <0.00)) in multivariable linear regression analysis, suggesting that cholesterol levels are much less predictive of coronary artery disease in the elderly as compared to the young. These results point to the need for a more finely tuned set of criteria for the evaluation of hypercholesterolemia, one that takes into account the age of the screenee.

Additional Information

Publication
Jacobsen SJ, Freedman DS, Hoffman RG, Gruchow HW, Anderson AJ, Barboriak JJ. Cholesterol and Coronary Artery Disease: Age as an Effect Modifier. Journal of Clinical Epidemiology 45:1053-1059, 1992.
Language: English
Date: 1992
Keywords
Cholesterol, Coronary disease, Age factors, Risk factors, Coronary angiography, Cross-sectional studies