To a larger extent than previously considered in medicine, elevated levels of cholesterol increase the long-term risk of suffering a heart attack; in particular for young people. This has been proven by a study of the Multinational Cardiovascular Risk Consortium led by researchers from the University Heart & Vascular Centre Hamburg published in The Lancet.
The cardiologists' new risk model applied in long-term projection shows that even a slightly elevated non-HDL level between 3.7 and 4.8 millimoles per litre (3.7 to <4.8 mmol/litre approximately corresponds with 145 to <185 miligrammes per decilitre – 145-<185 mg/dl – which is the measurement customarily used in Germany) increases the heart attack risk for a 40-year-old woman by the factor of 1.8. The risk for a man of the same age is doubled compared to persons without increased levels of cholesterol. However, cholesterol at the same level together with other factors such as diabetes or smoking, means that suffering a heart attack or a stroke at some point can reach probability levels of up to 29%.
So far, the risk of heart attacks for persons with elevated levels of blood lipids has only been calculated for the subsequent ten years, which frequently did not show any increased risks, in particular where young people were concerned. On the basis of the completed study, it is now possible to approximately predict the lifetime risk.
With the newly developed risk model, the researchers have also calculated the hypothetical risk for the same people with a non-HDL figure reduced by 30 or 50 percent. This significantly reduces the risk of heart attacks. For a 40-year-old man with no additional risk factors, this means a decrease from 19 to approximately 4 percent. Every day, uncountable patients and doctors face the decision of implementing cholesterol-reducing measures such as statin medication. In such situations, the model can assist in the decision-making process.
The data analyses that run for three years are based on a harmonized model that considers data from the USA and Australia in addition to data from European countries. The data of some 400,000 participants in 38 prospective population-based studies from 19 countries allowed to draw conclusions on the development of cardiovascular diseases in relation to the cholesterol levels measured in the participants in the studies over a period of up to 43 years. This provides very good assistance in decision-making on therapy when communicating with patients on the issue of preventing cardiovascular diseases.