Projects per year
Abstract
Background
Unhealthy lifestyle is a major risk factor for coronary heart disease, which may be explained by elevated remnant cholesterol. However, this question remains incompletely clarified. In this study, we aimed to investigate whether elevated remnant cholesterol explains part of the excess risk of myocardial infarction and coronary heart disease in individuals with unhealthy lifestyle.
Methods
We included 104,867 individuals (58,286 women and 46,581 men) from the Copenhagen General Population Study free from coronary heart disease at examination. During a median follow-up of 9.2 years, 2484 developed myocardial infarction and 3570 developed coronary heart disease. To understand explained risk from elevated remnant cholesterol due to unhealthy lifestyle on risk of myocardial infarction and coronary heart disease, we used mediation analyses.
Findings
Current smoking, low physical activity, and low adherence to dietary guidelines were all associated with higher levels of remnant cholesterol. For current smoking, remnant cholesterol explained 15% (95% confidence interval: 9.7%–20%) of the excess risk of myocardial infarction and 16% (11%–21%) of the excess risk of coronary heart disease. Corresponding values for low physical activity were 20% (13%–27%) and 21% (15%–28%), and for low adherence to dietary guidelines 12% (6.6%–18%) and 14% (8.0%–19%), respectively. Results were similar in women and men separately and in analyses where each lifestyle factor were additionally adjusted for the other three lifestyle factors.
Interpretation
Elevated remnant cholesterol explained part of excess myocardial infarction and coronary heart disease in individuals with an unhealthy lifestyle. Clinically, these novel findings underline the importance of both elevated remnant cholesterol and promotion of healthy lifestyle in primary prevention of myocardial infarction and coronary heart disease.
Funding
Independent Research Fund Denmark; Johan Boserup and Lise Boserups Grant; Medical Research Council.
Unhealthy lifestyle is a major risk factor for coronary heart disease, which may be explained by elevated remnant cholesterol. However, this question remains incompletely clarified. In this study, we aimed to investigate whether elevated remnant cholesterol explains part of the excess risk of myocardial infarction and coronary heart disease in individuals with unhealthy lifestyle.
Methods
We included 104,867 individuals (58,286 women and 46,581 men) from the Copenhagen General Population Study free from coronary heart disease at examination. During a median follow-up of 9.2 years, 2484 developed myocardial infarction and 3570 developed coronary heart disease. To understand explained risk from elevated remnant cholesterol due to unhealthy lifestyle on risk of myocardial infarction and coronary heart disease, we used mediation analyses.
Findings
Current smoking, low physical activity, and low adherence to dietary guidelines were all associated with higher levels of remnant cholesterol. For current smoking, remnant cholesterol explained 15% (95% confidence interval: 9.7%–20%) of the excess risk of myocardial infarction and 16% (11%–21%) of the excess risk of coronary heart disease. Corresponding values for low physical activity were 20% (13%–27%) and 21% (15%–28%), and for low adherence to dietary guidelines 12% (6.6%–18%) and 14% (8.0%–19%), respectively. Results were similar in women and men separately and in analyses where each lifestyle factor were additionally adjusted for the other three lifestyle factors.
Interpretation
Elevated remnant cholesterol explained part of excess myocardial infarction and coronary heart disease in individuals with an unhealthy lifestyle. Clinically, these novel findings underline the importance of both elevated remnant cholesterol and promotion of healthy lifestyle in primary prevention of myocardial infarction and coronary heart disease.
Funding
Independent Research Fund Denmark; Johan Boserup and Lise Boserups Grant; Medical Research Council.
| Original language | English |
|---|---|
| Article number | 101223 |
| Number of pages | 16 |
| Journal | The Lancet Regional Health - Europe |
| Volume | 51 |
| Early online date | 7 Feb 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 7 Feb 2025 |
Bibliographical note
Publisher Copyright:© 2025 The Author(s)
Research Groups and Themes
- Bristol Population Health Science Institute
Fingerprint
Dive into the research topics of 'Association of remnant cholesterol with unhealthy lifestyle and risk of coronary heart disease: a population-based cohort study'. Together they form a unique fingerprint.Projects
- 1 Active
-
Integrative Epidemiology Unit
Davey Smith, G. (Principal Investigator)
1/04/23 → 31/03/28
Project: Research