Limits...
Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study.

Petursson H, Sigurdsson JA, Bengtsson C, Nilsen TI, Getz L - J Eval Clin Pract (2011)

Bottom Line: Our study provides an updated epidemiological indication of possible errors in the CVD risk algorithms of many clinical guidelines.If our findings are generalizable, clinical and public health recommendations regarding the 'dangers' of cholesterol should be revised.This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.

View Article: PubMed Central - PubMed

Affiliation: Research Unit of General Practice, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. halfdanpe@gmail.com

Show MeSH

Related in: MedlinePlus

Risk of death from ischaemic heart disease associated with different levels of total cholesterol. Hazard ratios and 95% confidence intervals for men (blue box) and women (red diamond). Adjusted for age, smoking and systolic blood pressure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3303886&req=5

fig04: Risk of death from ischaemic heart disease associated with different levels of total cholesterol. Hazard ratios and 95% confidence intervals for men (blue box) and women (red diamond). Adjusted for age, smoking and systolic blood pressure.

Mentions: Among men, cholesterol did not seem to be linearly associated with mortality but rather the association followed a U-shaped pattern, with the lowest mortality appearing in the second cholesterol category (5.0–5.9 mmol L−1). This was apparent in all mortality categories. Consequently, cholesterol analysed as a continuous variable did not show a statistically significant linear association with mortality. Test for quadratic trend yielded P = 0.01 for all-cause mortality (indicating a true U-curve), P = 0.055 for CVD (approaching statistical significance) and P = 0.80 for IHD (practically excluding a U-curve). The associations between cholesterol and mortality are visualized in Figs 2–4.


Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study.

Petursson H, Sigurdsson JA, Bengtsson C, Nilsen TI, Getz L - J Eval Clin Pract (2011)

Risk of death from ischaemic heart disease associated with different levels of total cholesterol. Hazard ratios and 95% confidence intervals for men (blue box) and women (red diamond). Adjusted for age, smoking and systolic blood pressure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3303886&req=5

fig04: Risk of death from ischaemic heart disease associated with different levels of total cholesterol. Hazard ratios and 95% confidence intervals for men (blue box) and women (red diamond). Adjusted for age, smoking and systolic blood pressure.
Mentions: Among men, cholesterol did not seem to be linearly associated with mortality but rather the association followed a U-shaped pattern, with the lowest mortality appearing in the second cholesterol category (5.0–5.9 mmol L−1). This was apparent in all mortality categories. Consequently, cholesterol analysed as a continuous variable did not show a statistically significant linear association with mortality. Test for quadratic trend yielded P = 0.01 for all-cause mortality (indicating a true U-curve), P = 0.055 for CVD (approaching statistical significance) and P = 0.80 for IHD (practically excluding a U-curve). The associations between cholesterol and mortality are visualized in Figs 2–4.

Bottom Line: Our study provides an updated epidemiological indication of possible errors in the CVD risk algorithms of many clinical guidelines.If our findings are generalizable, clinical and public health recommendations regarding the 'dangers' of cholesterol should be revised.This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.

View Article: PubMed Central - PubMed

Affiliation: Research Unit of General Practice, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. halfdanpe@gmail.com

Show MeSH
Related in: MedlinePlus