Effects of Systolic BP and LDL-C on Cardiovascular Risk Are Cumulative

Low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP) have independent, multiplicative, and cumulative causal effects on lifetime cardiovascular disease (CVD) risk, and the combination of lowered LDL-C and lowered SBP over time can significantly reduce lifetime CVD risk, according to new research.

The findings were presented at the European Society of Cardiology Congress 2016 on August 29, 2016.¹
____________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Are Higher LDL-C Levels Harmful for Older Adults?
Beans Great for Reducing LDL Cholesterol
____________________________________________________________________________________________________________________________________________________________________

While previous research has shown that lower levels of LDL-C and SBP are associated with low lifetime CVD risk, the causal effects of combined lowering of these factors is less well understood.

To explore this relationship, the researchers performed a 2 × 2 factorial Mendelian study using genetic and cardiovascular risk-factor data from 102,773 participants in 14 prospective cohort or case-control studies.

The researchers used genetic LDL-C and blood pressure scores to naturally randomize participants to 4 groups: those with a lower LDL-C level, lower SBP, both, or neither (reference group).

During up to 32 years of follow-up, 14,368 major vascular events—including a composite of major vascular event, coronary heart disease death, myocardial infarction, stroke, or coronary revascularizations—occurred.

Analysis showed that the risk of major vascular events was reduced by 54.2% in the lower LDL-C group, 44.7% in the lower SBP group, and 86.1% in the combined lower LDL-C and SBP group vs the reference group.

“The results demonstrate for the first time that LDL cholesterol and systolic blood pressure have independent, multiplicative, and cumulative causal effects on the risk of CVD,” the researchers concluded. “Our study confirms that CVD events are largely preventable.”²

—Amanda Balbi

Reference:

1. Ference BA. A naturally randomized trial comparing the effect of long-term exposure to LDL-C, lower SBP, or both on the risk of cardiovascular disease. Paper presented at: European Society of Cardiology (ESC) Congress 2016; August 29, 2016; Rome, Italy. Abstract 3163. http://congress365.escardio.org/Presentation/142571#.V8XK9pMrK-q. Accessed August 30, 2016.

2. A combination concept for ‘dramatic’ lower risk. ESC Congress News Rome 2016. August 30, 2016:2. http://www.escardio.org/static_file/Escardio/Web/Congresses/congress-news/2016/ESC%20Congress/4-Tuesday/tuesday-30-aug.pdf. Accessed August 30, 2016.