Risk of cardiovascular mortality in relation to optimal low-density lipoprotein cholesterol combined with hypertriglyceridemia: is there a difference by gender?

PURPOSE

The objectives of the present study were to determine whether an optimal low-density lipoprotein cholesterol (LDL-C) combined with hypertriglyceridemia was associated with cardiovascular disease (CVD) mortality and whether these associations differ by gender.

METHODS

A cohort of 2903 U.S. adults aged ≥45 years (men) and ≥55 years (women) at baseline (1988-1994) was followed through December 2006 for CVD mortality. Baseline data were collected through the Third National Health and Nutrition Examination Survey (NHANES III). The definitions of high LDL-C and high triglycerides (TG) (hypertriglyceridemia) levels were based on the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines. Cox proportional hazard models were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) of death.

RESULTS

After adjusting for age, race/ethnicity, and traditional CVD risk factors, the risk of CVD death was approximately two times as high among women with optimal LDL-C/hypertriglyceridemia (2.42, 95% CI = 1.35-4.33) compared to women with optimal LDL-C/normal TG. In contrast, no significant difference was found among men on this comparison.

CONCLUSIONS

Judging from this study, hypertriglyceridemia is associated with an increased risk of CVD mortality in women but not in men. The association is independent of abnormal LDL-C effect.