Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55 000 vascular deaths

@article{Lewington2007BloodCA,
  title={Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55 000 vascular deaths},
  author={Sarah Lewington and Gary George Whitlock and Robert J. Clarke and Paul Sherliker and Jonathan R. Emberson and Jim Halsey and Nawab Qizilbash and Richard Peto and Rory Collins},
  journal={The Lancet},
  year={2007},
  volume={370},
  pages={1829-1839}
}
BACKGROUND Age, sex, and blood pressure could modify the associations of total cholesterol (and its main two fractions, HDL and LDL cholesterol) with vascular mortality. This meta-analysis combined prospective studies of vascular mortality that recorded both blood pressure and total cholesterol at baseline, to determine the joint relevance of these two risk factors. METHODS Information was obtained from 61 prospective observational studies, mostly in western Europe or North America… Expand

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References

SHOWING 1-10 OF 25 REFERENCES
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies
TLDR
Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg. Expand
Cholesterol, diastolic blood pressure, and stroke: 13 000 strokes in 450 000 people in 45 prospective cohorts
TLDR
The associations of blood cholesterol and diastolic blood pressure with subsequent stroke rates were investigated by review of 45 prospective observational cohorts involving 450,000 individuals with 5-30 years of follow-up, finding that the effects of therapeutic blood pressure reductions should be assessed separately in middle age and in old age. Expand
Influence of total cholesterol, high density lipoprotein cholesterol, and triglycerides on risk of cerebrovascular disease: the Copenhagen city heart study
TLDR
The pattern of the association between plasma cholesterol and risk of ischaemic cerebrovascular disease was not log linear, and the increased risk was confined to the upper 5% of the cholesterol distribution. Expand
High-density lipoprotein cholesterol and risk of ischemic stroke mortality. A 21-year follow-up of 8586 men from the Israeli Ischemic Heart Disease Study.
TLDR
In this prospective study of middle-aged and elderly men from a healthy, working population, an independent negative association between HDL-C and ischemic stroke mortality during a long-term (21-year) follow-up is demonstrated. Expand
Joint Effects of Systolic Blood Pressure and Serum Cholesterol on Cardiovascular Disease in the Asia Pacific Region
TLDR
In Asia-Pacific populations, there are hazards of increasing SBP at all cholesterol levels and hazards of increase cholesterol at all levels of SBP, but the associations ofSBP with CHD risk and ischemic stroke risk are slightly steeper among those with low cholesterol levels. Expand
Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial.
TLDR
It is concluded that there is an inverse relation between the serum cholesterol level and the risk of death from hemorrhagic stroke in middle-aged American men, but that its public health impact is overwhelmed by the positive association of higher serum cholesterol levels with death from nonhemorrhagic stroke and total cardiovascular disease. Expand
HDL-Cholesterol, total cholesterol, and the risk of stroke in middle-aged British men.
TLDR
Higher levels of HDL cholesterol were associated with a significant decrease in risk of stroke even after adjustment for potential confounders and the marked inverse association between HDL cholesterol and stroke seen in hypertensives emphasizes the importance of those modifiable risk factors for stroke known to lower the concentrations of HDLolesterol. Expand
Combined effects of systolic blood pressure and total cholesterol on cardiovascular disease risk.
TLDR
This meta-analysis differs from previous studies in several ways: It is the largest study from this region, involving >3000 CHD events and 4000 stroke events; individual records were available for each of the participants in each study, with cause and age of death (if applicable); and information on several thousand repeat measurements of blood pressure and cholesterol made during prolonged follow-up allowed correction for "regression dilution". Expand
Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins
TLDR
Statin therapy can safely reduce the 5-year incidence of major coronary events, coronary revascularisation, and stroke by about one fifth per mmol/L reduction in LDL cholesterol, largely irrespective of the initial lipid profile or other presenting characteristics. Expand
Plasma Lipid Profile and Incident Ischemic Stroke: The Atherosclerosis Risk in Communities (ARIC) Study
TLDR
The relation of circulating cholesterol to ischemic stroke does not resemble its well-known relation to coronary heart disease. Expand
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1
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