Original Article: Gender difference of association between LDL cholesterol concentrations and mortality from coronary heart disease amongst Japanese: the Ibaraki Prefectural Health Study

Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Shuita-shi, Osaka, Japan.
Journal of Internal Medicine (Impact Factor: 6.06). 10/2009; 267(6):576-87. DOI: 10.1111/j.1365-2796.2009.02183.x
Source: PubMed


The aim of this study was to examine whether LDL cholesterol raises the risk of coronary heart disease in a dose-response fashion in a population with low LDL-cholesterol levels.
Population-based prospective cohort study in Japan.
A total of 30,802 men and 60,417 women, aged 40 to 79 years with no history of stroke or coronary heart disease, completed a baseline risk factor survey in 1993. Systematic mortality surveillance was performed through 2003 and 539 coronary heart disease deaths were identified.
The mean values for LDL-cholesterol were 110.5 mg dL(-1) (2.86 mmol L(-1)) for men and 123.9 mg dL(-1) (3.20 mmol L(-1)) for women. Men with LDL-cholesterol > or =140 mg dL(-1) (> or =3.62 mmol L(-1)) had two-fold higher age-adjusted risk of mortality from coronary heart disease than did those with LDL-cholesterol <80 mg dL(-1) (<2.06 mmol L(-1)), whereas no such association for women was found. The multivariable hazard ratio for the highest versus lowest categories of LDL-cholesterol was 2.06 (95 percent confidence interval: 1.34 to 3.17) for men and 1.16 (0.64 to 2.12) for women.
Higher concentrations of LDL-cholesterol were associated with an increased risk of mortality from coronary heart disease for men, but not for women, in a low cholesterol population.

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    • "Several recent studies in Japan reported that all-cause mortality among individuals with the highest total cholesterol levels was lower than in the other individuals (Ogushi and Kurita, 2008; Noda et al., 2010; Nago et al., 2011; Hamazaki et al., 2012a). Hamazaki et al. (2012b) reported that almost all epidemiological studies in Japan showed that all-cause mortality was lower in subjects with high levels of total cholesterol. "
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    • "remained significant after multivariable adjustment. In the Ibaraki Prefectural Health Study, which was a very large sample consisting of 30,802 men and 60,417 women, high LDL cholesterol levels were associated with an increased risk of mortality from coronary heart disease in men, but not in women [40]. The same study showed that lower LDL cholesterol levels are associated with elevated risk of mortality from intracerebral hemorrhage, but are not associated with increasing risk of cerebral infarction [41]. "
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