Low-density lipoprotein cholesterol was inversely associated with 3-year all-cause mortality among Chinese oldest old: Data from the Chinese Longitudinal Healthy Longevity Survey

Objective: Low-density lipoprotein cholesterol (LDL-C) is a risk factor for survival in middle-aged individuals, but conflicting evidence exists on the relationship between LDL-C and all-cause mortality among the elderly. The goal of this study was to assess the relationship between LDL-C and all-cause mortality among Chinese oldest old (aged 80 and older) in a prospective cohort study. Methods: LDL-C concentrationwas measured at baseline and all-cause mortality was calculated over a 3year period. Multiple statistical models were used to adjust for demographic and biological covariates. Results: During three years of follow-up, 447 of 935 participants died, and the overall all-cause mortality was 49.8%. Each 1 mmol/L increase of LDL-C concentration corresponded to a 19% decrease in 3-year allcause mortality (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.71-0.92). The crude HR for abnormally higher LDL-C concentration (>= 3.37 mmol/L) was 0.65 (0.41-1.03); and the adjusted HR was statistically significant around 0.60 (0.37-0.95) when adjusted for different sets of confounding factors. Results of sensitivity analysis also showed a significant association between higher LDL-C and lower mortality risk. Conclusions: Among the Chinese oldest old, higher LDL-C level was associated with lower risk of allcause mortality. Our findings suggested the necessity of re-evaluating the optimal level of LDL-C among the oldest old. (C) 2015 Published by Elsevier Ireland Ltd.Peripheral Vascular DiseaseSCI(E)PubMed0ARTICLEshixm@chinacdc.cn; david.matchar@duke-nus.edu.sg; zengyi68@gmail.com1137-14223