Association between systolic blood pressure and low-density lipoprotein cholesterol with coronary heart disease according to age
File(s)
Published version
Author(s)
Wang, Nelson
Mustafa, Rima
Zuber, Verena
Rodgers, Anthony
Dehghan, Abbas
Type
Journal Article
Abstract
BACKGROUND: The impact of elevated systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) on the risk of coronary heart disease (CHD) at different stages of life is unclear. We aimed to investigate whether genetically mediated SBP/LDL-C is associated with the risk of CHD throughout life. METHODS AND FINDINGS: We conducted a three-sample Mendelian randomization analysis using data from the UK Biobank including 136,648 participants for LDL-C, 135,431 participants for SBP, and 24,052 cases for CHD to assess the effect of duration of exposure to the risk factors on risk of CHD. Analyses were stratified by age at enrolment. In univariable analyses, there was a consistent association between exposure to higher LDL-C and SBP with increased odds of incident CHD in individuals aged ≤55 years, ≤60 years, and ≤65 years (p-value for heterogeneity = 1.00 for LDL-C and 0.67 for SBP, respectively). In multivariable Mendelian randomization analyses, exposure to elevated LDL-C/SBP early in life (age ≤55 years) was associated with a higher risk of CHD independent of later life levels (age >55 years) (odds ratio 1.68, 95% CI 1.20-2.34 per 1 mmol/L LDL-C, and odds ratio 1.33, 95% CI 1.18-1.51 per 10 mmHg SBP). CONCLUSIONS: Genetically predicted SBP and LDL-C increase the risk of CHD independent of age. Elevated SBP and LDL-C in early to middle life is associated with increased CHD risk independent of later-life SBP and LDL-C levels. These findings support the importance of lifelong risk factor control in young individuals, whose risk of CHD accumulates throughout life.
Date Issued
2023-12-20
Date Acceptance
2023-11-14
Citation
PLoS One, 2023, 18 (12)
ISSN
1932-6203
Publisher
Public Library of Science (PLoS)
Journal / Book Title
PLoS One
Volume
18
Issue
12
Copyright Statement
Copyright: © 2023 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Identifier
PII: PONE-D-23-20632
Subjects
Autonomic Nervous System Diseases
Blood Pressure
Cholesterol, LDL
Coronary Disease
Humans
Mendelian Randomization Analysis
Risk Factors
Publication Status
Published
Coverage Spatial
United States
Article Number
e0295004
Date Publish Online
2023-12-20