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The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women's health in the Lund area (WHILA) : a 17-year follow-up cohort study

Calling, Susanna LU ; Johansson, Sven-Erik LU ; Wolff, Moa LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2019) In BMC Cardiovascular Disorders 19(1).
Abstract

BACKGROUND: Identifying variables predictive of acute myocardial infarction (AMI) in women is important. The use of the ratio of total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) is often overlooked. The aim was to study TC/HDL-C in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist-hip ratio, blood pressure, and neighbourhood socioeconomic status. The hypothesis was that increasing TC/HDL-C is associated with an increased risk of later AMI.

METHODS: From December 1995 to February 2000, 6147 women aged 50-59 years from the Womens' Health in Lund area (WHILA) study in southern Sweden underwent a physical examination, laboratory tests and filled in a... (More)

BACKGROUND: Identifying variables predictive of acute myocardial infarction (AMI) in women is important. The use of the ratio of total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) is often overlooked. The aim was to study TC/HDL-C in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist-hip ratio, blood pressure, and neighbourhood socioeconomic status. The hypothesis was that increasing TC/HDL-C is associated with an increased risk of later AMI.

METHODS: From December 1995 to February 2000, 6147 women aged 50-59 years from the Womens' Health in Lund area (WHILA) study in southern Sweden underwent a physical examination, laboratory tests and filled in a questionnaire. The women were followed through national registers for incidence of AMI during a mean follow up of 17 years.

RESULTS: An increasing TC/HDL-C showed a strong relationship with AMI, with the lowest hazard ratio (HR = 1) in women with a ratio of ≤3.5. The HR for AMI was 1.14 (95% CI: 0.73-1.78) for those with a ratio between 3.5 and 4.0; in those with a ratio between 4.0 and 5.0 the HR for AMI was 1.46 (95% CI: 1.00-2.13) and in those with a ratio > 5.0 the HR was 1.89 (95% CI 1.26-2.82), after adjusting for potential confounding factors.

CONCLUSIONS: TC/HDL-C ratio is a powerful predictor of AMI in middle-aged women. The results indicate that this variable should be used in clinical practice and is important for early identification of individuals at risk of AMI.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomarkers/blood, Cholesterol/blood, Cholesterol, HDL/blood, Dyslipidemias/blood, Follow-Up Studies, Humans, Middle Aged, Myocardial Infarction/blood, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, Sweden/epidemiology, Time Factors, Women's Health
in
BMC Cardiovascular Disorders
volume
19
issue
1
article number
239
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85074350542
  • pmid:31664919
ISSN
1471-2261
DOI
10.1186/s12872-019-1228-7
language
English
LU publication?
yes
id
d3e5e1fa-67b0-41b5-8c98-3fbb54ceaa7f
date added to LUP
2023-12-18 15:26:27
date last changed
2024-04-03 13:19:09
@article{d3e5e1fa-67b0-41b5-8c98-3fbb54ceaa7f,
  abstract     = {{<p>BACKGROUND: Identifying variables predictive of acute myocardial infarction (AMI) in women is important. The use of the ratio of total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) is often overlooked. The aim was to study TC/HDL-C in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist-hip ratio, blood pressure, and neighbourhood socioeconomic status. The hypothesis was that increasing TC/HDL-C is associated with an increased risk of later AMI.</p><p>METHODS: From December 1995 to February 2000, 6147 women aged 50-59 years from the Womens' Health in Lund area (WHILA) study in southern Sweden underwent a physical examination, laboratory tests and filled in a questionnaire. The women were followed through national registers for incidence of AMI during a mean follow up of 17 years.</p><p>RESULTS: An increasing TC/HDL-C showed a strong relationship with AMI, with the lowest hazard ratio (HR = 1) in women with a ratio of ≤3.5. The HR for AMI was 1.14 (95% CI: 0.73-1.78) for those with a ratio between 3.5 and 4.0; in those with a ratio between 4.0 and 5.0 the HR for AMI was 1.46 (95% CI: 1.00-2.13) and in those with a ratio &gt; 5.0 the HR was 1.89 (95% CI 1.26-2.82), after adjusting for potential confounding factors.</p><p>CONCLUSIONS: TC/HDL-C ratio is a powerful predictor of AMI in middle-aged women. The results indicate that this variable should be used in clinical practice and is important for early identification of individuals at risk of AMI.</p>}},
  author       = {{Calling, Susanna and Johansson, Sven-Erik and Wolff, Moa and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{1471-2261}},
  keywords     = {{Biomarkers/blood; Cholesterol/blood; Cholesterol, HDL/blood; Dyslipidemias/blood; Follow-Up Studies; Humans; Middle Aged; Myocardial Infarction/blood; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; Risk Factors; Sweden/epidemiology; Time Factors; Women's Health}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Cardiovascular Disorders}},
  title        = {{The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women's health in the Lund area (WHILA) : a 17-year follow-up cohort study}},
  url          = {{http://dx.doi.org/10.1186/s12872-019-1228-7}},
  doi          = {{10.1186/s12872-019-1228-7}},
  volume       = {{19}},
  year         = {{2019}},
}