PMID: identifier of
Pubmed reference: |
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 (21487128)  |
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| title: |
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Decline in low-density lipoprotein cholesterol concentration: lipid-lowering drugs, diet, or physical activity? Evidence from the Whitehall II study. |
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| author(s): |
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Kim Bouillon ( ) 1, 2, Archana Singh-Manoux1, 2, 3, Markus Jokela1, 4, Martin Shipley1, David Batty1, Eric Brunner1, Séverine Sabia2, Adam Tabák1, 5, Tasnime Akbaraly1, 6, Jane Ferrie1, Mika Kivimäki1, 7 |
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| laboratory: |
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| short title : |
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Predictors of declines in LDL-cholesterol |
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| abstract: |
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OBJECTIVE: To examine the association of lipid-lowering drugs, change in diet and physical activity with a decline in low-density lipoprotein (LDL) cholesterol in middle age. DESIGN: A prospective cohort study. SETTING: The Whitehall II study. PARTICIPANTS: 4469 British civil servants (72% men) aged 39-62 years at baseline. MAIN OUTCOME MEASURE: Change in LDL-cholesterol concentrations between the baseline (1991-3) and follow-up (2003-4). RESULTS: Mean LDL-cholesterol decreased from 4.38 to 3.52 mmol/l over a mean follow-up of 11.3 years. In a mutually adjusted model, a decline in LDL-cholesterol was greater among those who were taking lipid-lowering treatment at baseline (-1.14 mmol/l, n=34), or started treatment during the follow-up (-1.77 mmol/l, n=481) compared with untreated individuals (n=3954; p<0.001); among those who improved their diet--especially the ratio of white to red meat consumption and the ratio of polyunsaturated to saturated fatty acids intake--(-0.07 mmol/l, n=717) compared with those with no change in diet (n=3071; p=0.03) and among those who increased physical activity (-0.10 mmol/l, n=601) compared with those with no change in physical activity (n=3312; p=0.005). Based on these estimates, successful implementation of lipid-lowering drug treatment for high-risk participants (n=858) and favourable changes in diet (n=3457) and physical activity (n=2190) among those with non-optimal lifestyles would reduce LDL-cholesterol by 0.90 to 1.07 mmol/l in the total cohort. CONCLUSIONS: Both lipid-lowering pharmacotherapy and favourable changes in lifestyle independently reduced LDL-cholesterol levels in a cohort of middle-aged men and women, supporting the use of multifaceted intervention strategies for prevention. |
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| subject: |
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Life Sciences/Health Care Sciences and Epidemiology
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| fulltext language: |
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English |
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| ISSN: |
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1355-6037 |
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| publication format: |
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Article in peer-reviewed journal |
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| DOI: |
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10.1136/hrt.2010.216309 |
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| journal: |
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| Heart |
| Publisher |
BMJ Publishing Group |
| ISSN |
0007-0769 |
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| Audience: |
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international |
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| publication date: |
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2011-06 |
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| submission date: |
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2011-04-12 |
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| volume: |
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97 |
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| issue: |
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11 |
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| page, identifiant, ...: |
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923-30 |
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| keyword(s) of author: |
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cohort study – LDL-cholesterol – lipid lowering drug – diet – physical activity |
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| MeSH Descriptor(s): |
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Adult – Cholesterol – LDL – Diet – Exercise Therapy – Female – Follow-Up Studies – Humans – Hypercholesterolemia – Hypolipidemic Agents – Life Style – London – Male – Middle Aged – Multivariate Analysis |
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| contract, financing: |
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The Whitehall II study has been supported by grants from the Medical Research Council, UK; Economic and Social Research Council, UK; British Heart Foundation, UK; Health and Safety Executive, UK; Department of Health, UK; BUPA Foundation, UK; National Heart Lung and Blood Institute (R01HL036310), US; NIH: National Institute on Aging (R01AG013196; R01AG034454), US. GDB is a Wellcome Trust Fellow (WBS U.1300.00.006.00012.01), UK. MJS is supported by the British Heart Foundation. MK is supported by the BUPA Foundation, UK, the Academy of Finland, Finland, and the EU OSH ERA research programme. |
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