Both very low and very high levels of LDL-C may increase CVD mortality: JAHA

USA: Very low and very high levels of LDL-C are both linked to an increased risk of cardiovascular disease (CVD) mortality, says a recent study published in the Journal of the American Heart Association. Very low levels of LDL-C were also tied to high risks of stroke and all-cause mortality. 

Very low low‐density lipoprotein cholesterol (LDL‐C) treatment targets are recommended for people at high CVD risk by the current cholesterol guidelines. Recent observational studies however have shown that very low LDL‐C levels may be associated with increased mortality and other adverse outcomes. There is a need to determine the association between LDL‐C levels and long‐term risk of overall and cardiovascular mortality among the U.S. general population.

Against the above background, Shuang Rong, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China, and colleagues aimed to evaluate the association between the LDL‐C levels and all‐cause and CVD mortality risk in a nationally representative cohort with up to 27 years of follow up in the general population.

A nationally representative sample of 14 035 adults aged 18 years or older were included, who participated in the National Health and Nutrition Examination Survey III 1988–1994. Categorization of LDL‐C levels was done into 6 categories: <70, 70–99.9, 100–129.9, 130–159.9, 160–189.9, and ≥190 mg/dL. By linking death records through December 31, 2015, deaths and underlying death causes were ascertained.