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In Elderly, HDL Key Predictor of Cardiovascular Disease

Statins could be targeted to those with low levels of 'good' cholesterol

MONDAY, Nov. 7 (HealthDay News) -- High-density lipoprotein cholesterol (HDLc) is a key predictor of cardiovascular disease risk in the elderly, and could be used to determine treatment benefit, according to results from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), published in the Nov. 15 issue of Circulation: Journal of the American Heart Association.

Chris J. Packard, D.Sc., of the University of Glasgow in Scotland, and colleagues evaluated the association between low-density lipoprotein cholesterol (LDLc), HDLc and heart disease risk in 5,804 patients aged 70 to 82.

Baseline LDLc was not associated with outcomes in either the placebo or pravastatin group. However, patients with HDLc in the lowest two quintiles experienced a 33% drop in risk with pravastatin compared with placebo. Those with higher HDLc showed no benefit, the researchers found.

In those over 70 years of age, "HDLc appears to be a key predictor of risk and of treatment benefit," the authors write. Statin therapy could be targeted to patients with HDLc of less than 1.15 mmol/L or to those with an LDLc-HDLc ratio greater than 3.3, they conclude.

The study was supported by a grant from Bristol-Myers Squibb.

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