Decline in low-density lipoprotein cholesterol concentration: lipid-lowering drugs, diet, or physical activity? Evidence from the Whitehall II study.: Predictors of declines in LDL-cholesterol

International audienceOBJECTIVE: To examine the association of lipid-lowering drugs, change in diet and physical activity with a decline in low-density lipoprotein (LDL) cholesterol in middle age. DESIGN: A prospective cohort study. SETTING: The Whitehall II study. PARTICIPANTS: 4469 British civil servants (72% men) aged 39-62 years at baseline. MAIN OUTCOME MEASURE: Change in LDL-cholesterol concentrations between the baseline (1991-3) and follow-up (2003-4). RESULTS: Mean LDL-cholesterol decreased from 4.38 to 3.52 mmol/l over a mean follow-up of 11.3 years. In a mutually adjusted model, a decline in LDL-cholesterol was greater among those who were taking lipid-lowering treatment at baseline (-1.14 mmol/l, n=34), or started treatment during the follow-up (-1.77 mmol/l, n=481) compared with untreated individuals (n=3954; p