UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
2016-07-05
Document Type
Article
Disciplines
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology
Abstract
BACKGROUND: Cross-sectional analyses suggest that total and low-density lipoprotein cholesterol (LDL-c) trends that had been declining are now reversing. We examined longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to examine secular trends in total cholesterol, LDL-c, high-density lipoprotein cholesterol (HDL-c), and triglycerides over 25 years. We also assessed whether modifiable lifestyle factors (body mass index, physical activity, alcohol consumption, smoking, and lipid-lowering medications) are associated with these trends.
METHODS AND RESULTS: CARDIA recruited 5115 black and white men and women ages 18 to 30 years from 4 US communities in 1985-1986, and re-examined them 5, 10, 15, 20, and 25 years later. Secular trends, modeled as age-matched time trends, were estimated using repeated-measures regression stratified on race and sex. Total cholesterol and LDL-c initially decreased approximately 5 to 8 mg/dL between visits before plateauing and moving toward adverse trends in all groups, except black women, by year 25. HDL-c showed an upward secular trend of 1 to 3 mg/dL between visits starting at year 15 in all groups; triglyceride trends were largely flat. Obesity and use of lipid-lowering medications, which both increased over follow-up, had strong independent, but opposite, associations with lipid trends over time. In aggregate, associations of modifiable lifestyle factors counterbalanced one another, minimally influencing secular trends.
CONCLUSIONS: Over 25 years, initially favorable trends in total cholesterol and LDL-c have leveled off and may be reversing, persisting after control for modifiable risk factors. Factors such as dietary changes over 25 years and poor adherence to medications are candidates for additional investigation.
Keywords
epidemiology, lipids, population, risk factor, UMCCTS funding
DOI of Published Version
10.1161/JAHA.116.003384
Source
J Am Heart Assoc. 2016 Jul 5;5(7). pii: e003384. doi: 10.1161/JAHA.116.003384. Link to article on publisher's site
Journal/Book/Conference Title
Journal of the American Heart Association
Related Resources
PubMed ID
27381757
Repository Citation
Schreiner PJ, Jacobs DR, Wong ND, Kiefe CI. (2016). Twenty-Five Year Secular Trends in Lipids and Modifiable Risk Factors in a Population-Based Biracial Cohort: The Coronary Artery Risk Development in Young Adults (CARDIA) Study, 1985-2011. Open Access Publications by UMass Chan Authors. https://doi.org/10.1161/JAHA.116.003384. Retrieved from https://escholarship.umassmed.edu/oapubs/2798
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Included in
Cardiology Commons, Cardiovascular Diseases Commons, Clinical Epidemiology Commons, Epidemiology Commons