From the Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
Department of Cardiology, Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Shinjuku, Japan.
Menopause. 2023 Aug 1;30(8):831-838. doi: 10.1097/GME.0000000000002215. Epub 2023 Jul 4.
Hormonal changes during menopause can disturb serum cholesterol which is closely associated with cardiovascular disease. This study investigated the prospective association between serum cholesterol and heart failure (HF) risk in postmenopausal women.
We analyzed data from 1,307 Japanese women, aged 55 to 94 years. All women had no history of HF, and their baseline brain natriuretic peptide (BNP) levels were less than 100 pg/mL. During the follow-ups conducted every 2 years, HF was diagnosed among women who developed BNP of 100 pg/mL or greater. Cox proportional hazard models were applied to calculate hazard ratios and 95% CI of HF for women per their baseline total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C) levels. The Cox regression models were adjusted for age, body mass index, smoking, alcohol drinking, hypertension, diabetes, cardiac murmurs, arrhythmia, stroke or ischemic heart disease, chronic kidney disease, and lipid-lowering agent use.
Within an 8-year median follow-up, 153 participants developed HF. In the multivariable-adjusted model, women with total cholesterol of 240 mg/dL or greater (compared with 160-199 mg/dL) and HDL-C of 100 mg/dL or greater (compared with 50-59 mg/dL) showed an increased risk of HF: hazard ratios (95% CI) = 1.70 (1.04-2.77) and 2.70 (1.10-6.64), respectively. The results remained significant after further adjusting for baseline BNP. No associations were observed with low-density lipoprotein cholesterol.
Total cholesterol of 240 mg/dL or greater and HDL-C of 100 mg/dL or greater were positively associated with the risk of HF in postmenopausal Japanese women.
绝经后激素变化可干扰与心血管疾病密切相关的血清胆固醇。本研究旨在探讨绝经后妇女血清胆固醇与心力衰竭（HF）风险之间的前瞻性关联。
我们分析了 1307 名年龄在 55 至 94 岁之间的日本女性的数据。所有女性均无 HF 病史，且基线脑钠肽（BNP）水平低于 100pg/ml。在每 2 年进行的随访期间，当女性的 BNP 达到 100pg/ml 或更高时，诊断为 HF。应用 Cox 比例风险模型计算 HF 的危险比（HR）和 95%CI，根据基线总胆固醇、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平对女性进行分层。Cox 回归模型调整了年龄、体重指数、吸烟、饮酒、高血压、糖尿病、心脏杂音、心律失常、卒中和缺血性心脏病、慢性肾脏病和降脂药物的使用。
在 8 年的中位随访期间，有 153 名参与者发生了 HF。在多变量调整模型中，总胆固醇为 240mg/dl 或更高（与 160-199mg/dl 相比）和 HDL-C 为 100mg/dl 或更高（与 50-59mg/dl 相比）的女性 HF 风险增加：HR（95%CI）分别为 1.70（1.04-2.77）和 2.70（1.10-6.64）。进一步调整基线 BNP 后，结果仍然显著。与 LDL-C 无相关性。
总胆固醇为 240mg/dl 或更高，HDL-C 为 100mg/dl 或更高与绝经后日本女性 HF 风险呈正相关。
