CHANGES IN TOTAL AND HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL OVER 10-YEAR AND 20-YEAR PERIODS (THE HONOLULU HEART PROGRAM)

Limited data are available on patterns of change in lipids and lipopro teins as persons age. The purpose of this report is to describe the 10 -year change in total and high-density lipoprotein (HDL) cholesterol a ccording to suspected determinants in 898 Japanese-American men enroll ed in the Honolulu Heart Program. Data are based on examinations that occurred from 1970 to 1972 and at repeat examinations received 10 and 20 years later, At the last examination, men were aged 71 to 93 years. Mean reductions in total cholesterol in the second 10 years of follow -up (24 mg/dl) were more than double the reductions observed in the fi rst 10 years (9 mg/dl). Levels of total cholesterol declined and level s of HDL cholesterol increased regardless of beginning levels of systo lic blood pressure, body mass index, physical activity, cigarette smok ing status, or the use of treatment for hypertension or elevated total cholesterol, Men with prevalent coronary heart disease experienced gr eater reductions (p <0.05) in total cholesterol during the second 10 y ears of follow-up (32 mg/dl) versus men without coronary heart disease (22 mg/dl), Adjustment for baseline covariates failed to alter these findings appreciably. We conclude that alterations in total and HDL ch olesterol with advancing age may be expected to occur regardless of ri sk factor status, disease prevalence, or pharmacologic intervention. I n the presence of such effects, evaluation of treatment programs to al ter levels of total and HDL cholesterol in older persons should consid er the possibility that even in the absence of intervention, changes c ould also occur due to aging alone. (C) 1998 by Excerpta Medico, Inc.