![]() ![]() The number of deaths from any cause was obtained from the Danish Civil Registration System, a complete register of all residents in Denmark since 1968 without losses to follow-up. Also, we identified the LDL-C level associated with the lowest mortality in individuals in the contemporary ongoing Copenhagen General Population Study. In this study, we determined the association between levels of LDL-C and the risk of all cause and cause specific mortality. Also, the concentration of LDL-C where the risk of mortality is lowest is not defined. 11 Thus the association between LDL-C levels and the risk of all cause and cause specific mortality in the general population is unclear. 11 Studies on the association between levels of LDL-C and cardiovascular mortality found different results, with some studies showing a positive association only 8 12 and some showing a U shaped association. Also, a recent study in young Koreans not taking lipid lowering drugs showed a U shaped relation between levels of LDL-C and mortality. 8 9 10 Most of these studies were conducted in individuals aged 65 and older, and in historical population based cohorts. Studies on the association between LDL-C levels and the risk of all cause mortality, however, have provided conflicting results, with some studies showing a counterintuitive inverse association (lower mortality with increasing levels of LDL-C) 5 6 7 and some showing no association. 1 2 3 4īecause lowering levels of LDL-C reduces cardiovascular disease outcomes, the general perception is that high levels of LDL-C are associated with an increased risk of mortality but low levels are not. Also, many randomised controlled trials of treatment with lipid lowering agents have clearly shown that lowering LDL-C levels reduces the risk of atherosclerotic cardiovascular events in the future. ![]() 1 High levels of LDL-C consistently predict a risk of future atherosclerotic cardiovascular events in a variety of populations throughout the world. ![]() Low density lipoprotein cholesterol (LDL-C) is a well established causal risk factor for the development of atherosclerosis and cardiovascular disease. Any increase in LDL-C levels was associated with an increased risk of myocardial infarction. Similar results were seen in men and women, across age groups, and for cancer and other mortality, but not for cardiovascular mortality. The concentration of LDL-C associated with the lowest risk of all cause mortality was 3.6 mmol/L (140 mg/dL) in the overall population and in individuals not receiving lipid lowering treatment, compared with 2.3 mmol/L (89 mg/dL) in individuals receiving lipid lowering treatment. Compared with individuals with concentrations of LDL-C of 3.4-3.9 mmol/L (132-154 mg/dL 61st-80th centiles), the multivariable adjusted hazard ratio for all cause mortality was 1.25 (95% confidence interval 1.15 to 1.36) for individuals with LDL-C concentrations of less than 1.8 mmol/L (189 mg/dL 96th-100th centiles). The association between levels of LDL-C and the risk of all cause mortality was U shaped, with low and high levels associated with an increased risk of all cause mortality. Results Among 108 243 individuals aged 20-100, 11 376 (10.5%) died during the study, at a median age of 81. ![]()
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