Mortality Predictors Associated with Extreme Levels of 'Bad' Cholesterol

Mortality Predictors Associated with Extreme Levels of 'Bad' Cholesterol

Levels of LDL cholesterol (LDL-C) (the “bad” cholesterol) of 190 mg/dl or higher, defined as severe hypercholesterolemia, have been linked to an increased risk of atherosclerotic cardiovascular disease (ASCVD) at a younger age. However, little is known about risk factors that contribute to death in the long-term for people with severe hypercholesterolemia.

Leandro Slipczuk Bustamante, M.D., Ph.D., and colleagues looked for contributors to mortality in a racially and ethnically diverse US patient cohort with LDL-C levels of 190 mg/dL or higher. They studied nearly 19,000 racially and ethnically diverse patients with at least one reading of severe hypercholesteremia who were treated at Montefiore Health System. Statin therapy is recommended as standard treatment for hypercholesterolemia, yet one-fourth of the patients were not taking statins. In addition to undertreatment with statins, the researchers identified several other factors that were independently associated with an increased mortality risk among these patients, including high levels of LDL-C and triglycerides, significantly low HDL cholesterol, hypertension, diabetes, and heart failure. The findings emphasize the need for people with severe hypercholesterolemia to maintain statin therapy and for physicians to manage comorbidities associated with mortality in patients with the condition. The study was published online on November 16 in Circulation.

Dr. Slipczuk Bustamante is an assistant professor of medicine at Einstein, section head of clinical cardiology, and director of the Advanced Cardiac Imaging Program and the Cardiovascular Atherosclerosis and Lipid Disorder Center at Montefiore.