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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:1444.)
© 2003 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Association of High Coronary Heart Disease Risk Status With Circulating Oxidized LDL in the Well-Functioning Elderly

Findings From the Health, Aging, and Body Composition Study

Paul Holvoet; Tamara B. Harris; Russell P. Tracy; Peter Verhamme; Anne B. Newman; Susan M. Rubin; Eleanor M. Simonsick; Lisa H. Colbert; Stephen B. Kritchevsky

From the Center for Experimental Surgery and Anesthesiology (P.H., P.V.), Katholieke Universiteit, Leuven, Belgium; the Intramural Research Program (T.B.H., E.M.S., L.H.C.), National Institute on Aging, National Institutes of Health, Bethesda, Md; the Department of Pathology (R.P.T.), University of Vermont, Burlington; the Division of Geriatric Medicine (A.B.N.), University of Pittsburgh, Pittsburgh, Pa; the Prevention Sciences Group (S.M.R.), University of California, San Francisco; and the Department of Preventative Medicine, University of Tennessee Health Science Center (S.B.K.), Memphis, Tenn.

Correspondence to Paul Holvoet, PhD, Center for Experimental Surgery and Anesthesiology (CEHA), University of Leuven, Campus Gasthuisberg, O&N, Herestraat 49, B-3000 Leuven, Belgium. E-mail paul.holvoet{at}med.kuleuven.ac.be

Objective— Although circulating oxidized LDL (oxLDL) is elevated in persons with coronary heart disease (CHD), whether oxLDL is elevated in persons with high CHD risk before any events is unknown. Therefore, we studied the association between high, predicted CHD risk and oxLDL in the Health ABC cohort.

Methods and Results— This cohort included 385 persons with CHD and 1183 persons at high risk; the latter were all persons with CHD risk equivalents: noncoronary forms of clinical atherosclerotic disease, diabetes, and a 10-year risk for CHD >20% by Framingham scoring. The remaining 1535 participants were at low risk. Levels of oxLDL were 1.18±0.61 mg/dL for low-risk persons, 1.50±0.81 mg/dL for high-risk persons without diagnosed CHD, and 1.32±0.83 mg/dL for persons with CHD (P<0.001). The odds ratio for high CHD risk in the highest quintile of oxLDL, compared with the lowest quintile and after adjusting for age, sex, race, LDL cholesterol, smoking status, and C-reactive protein, was 2.79 (P<0.001).

Conclusion— The odds ratio for elevated oxLDL among persons with high CHD risk before any CHD events was higher than that among persons with established CHD. A likely explanation is that once CHD is diagnosed, individuals are frequently treated with a statin, which is associated with lowering of LDL cholesterol and oxLDL levels.

Key Words: atherosclerosis • coronary heart disease • cardiovascular risk • lipoproteins • oxidized lipids

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