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

ObjectiveTo 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.DesignA prospective cohort study.SettingThe Whitehall II study.Participants4469 British civil servants (72% men) aged 39–62 year... Full description

Journal Title: Heart 2011-06, Vol.97 (11), p.923-930
Main Author: Bouillon, Kim
Other Authors: Singh-Manoux, Archana , Jokela, Markus , Shipley, Martin J , Batty, G David , Brunner, Eric J , Sabia, Séverine , Tabák, Adam G , Akbaraly, Tasnime , Ferrie, Jane E , Kivimäki, Mika
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: London: BMJ Publishing Group Ltd and British Cardiovascular Society
ID: ISSN: 1355-6037
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3090125
title: Decline in low-density lipoprotein cholesterol concentration: lipid-lowering drugs, diet, or physical activity? Evidence from the Whitehall II study
format: Article
creator:
  • Bouillon, Kim
  • Singh-Manoux, Archana
  • Jokela, Markus
  • Shipley, Martin J
  • Batty, G David
  • Brunner, Eric J
  • Sabia, Séverine
  • Tabák, Adam G
  • Akbaraly, Tasnime
  • Ferrie, Jane E
  • Kivimäki, Mika
subjects:
  • 1506
  • Adult
  • Antilipemic agents
  • Bias
  • Biological and medical sciences
  • Cardiology. Vascular system
  • Cardiovascular disease
  • Cholesterol
  • Cholesterol, LDL
  • Cholesterol, LDL - metabolism
  • Cohort study
  • Diet
  • Dosage and administration
  • Drugs
  • Epidemiology
  • Exercise
  • Exercise Therapy
  • Female
  • Follow-Up Studies
  • Food
  • Humans
  • Hypercholesterolemia - therapy
  • Hypolipidemic Agents - therapeutic use
  • LDL-cholesterol
  • Life Style
  • Lifestyles
  • lipid
  • lipid lowering
  • lipid-lowering drug
  • Lipids
  • lipids (amino acids
  • lipoproteins
  • London
  • Low density lipoprotein
  • lowering drug
  • Male
  • Measurement
  • Medical sciences
  • Middle Aged
  • Multivariate Analysis
  • Nutrition research
  • peptides
  • physical activity
  • Physiological aspects
  • Population
  • proteins
  • public health
  • Questionnaires
  • Studies
  • Trends
ispartof: Heart, 2011-06, Vol.97 (11), p.923-930
description: ObjectiveTo 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.DesignA prospective cohort study.SettingThe Whitehall II study.Participants4469 British civil servants (72% men) aged 39–62 years at baseline.Main Outcome MeasureChange in LDL-cholesterol concentrations between the baseline (1991–3) and follow-up (2003–4).ResultsMean 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
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titleDecline in low-density lipoprotein cholesterol concentration: lipid-lowering drugs, diet, or physical activity? Evidence from the Whitehall II study
sourceAlma/SFX Local Collection
creatorBouillon, Kim ; Singh-Manoux, Archana ; Jokela, Markus ; Shipley, Martin J ; Batty, G David ; Brunner, Eric J ; Sabia, Séverine ; Tabák, Adam G ; Akbaraly, Tasnime ; Ferrie, Jane E ; Kivimäki, Mika
creatorcontribBouillon, Kim ; Singh-Manoux, Archana ; Jokela, Markus ; Shipley, Martin J ; Batty, G David ; Brunner, Eric J ; Sabia, Séverine ; Tabák, Adam G ; Akbaraly, Tasnime ; Ferrie, Jane E ; Kivimäki, Mika
descriptionObjectiveTo 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.DesignA prospective cohort study.SettingThe Whitehall II study.Participants4469 British civil servants (72% men) aged 39–62 years at baseline.Main Outcome MeasureChange in LDL-cholesterol concentrations between the baseline (1991–3) and follow-up (2003–4).ResultsMean 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<0.001); among those who improved their diet—especially the ratio of white to red meat consumption and the ratio of polyunsaturated to saturated fatty acids intake—(−0.07 mmol/l, n=717) compared with those with no change in diet (n=3071; p=0.03) and among those who increased physical activity (−0.10 mmol/l, n=601) compared with those with no change in physical activity (n=3312; p=0.005). Based on these estimates, successful implementation of lipid-lowering drug treatment for high-risk participants (n=858) and favourable changes in diet (n=3457) and physical activity (n=2190) among those with non-optimal lifestyles would reduce LDL-cholesterol by 0.90 to 1.07 mmol/l in the total cohort.ConclusionsBoth lipid-lowering pharmacotherapy and favourable changes in lifestyle independently reduced LDL-cholesterol levels in a cohort of middle-aged men and women, supporting the use of multifaceted intervention strategies for prevention.
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2DOI: 10.1136/hrt.2010.216309
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languageeng
publisherLondon: BMJ Publishing Group Ltd and British Cardiovascular Society
subject1506 ; Adult ; Antilipemic agents ; Bias ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular disease ; Cholesterol ; Cholesterol, LDL ; Cholesterol, LDL - metabolism ; Cohort study ; Diet ; Dosage and administration ; Drugs ; Epidemiology ; Exercise ; Exercise Therapy ; Female ; Follow-Up Studies ; Food ; Humans ; Hypercholesterolemia - therapy ; Hypolipidemic Agents - therapeutic use ; LDL-cholesterol ; Life Style ; Lifestyles ; lipid ; lipid lowering ; lipid-lowering drug ; Lipids ; lipids (amino acids ; lipoproteins ; London ; Low density lipoprotein ; lowering drug ; Male ; Measurement ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Nutrition research ; peptides ; physical activity ; Physiological aspects ; Population ; proteins ; public health ; Questionnaires ; Studies ; Trends
ispartofHeart, 2011-06, Vol.97 (11), p.923-930
rights
02011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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2Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
32011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. 2011
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2Jokela, Markus
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5Brunner, Eric J
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7Tabák, Adam G
8Akbaraly, Tasnime
9Ferrie, Jane E
10Kivimäki, Mika
title
0Decline in low-density lipoprotein cholesterol concentration: lipid-lowering drugs, diet, or physical activity? Evidence from the Whitehall II study
1Heart
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descriptionObjectiveTo 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.DesignA prospective cohort study.SettingThe Whitehall II study.Participants4469 British civil servants (72% men) aged 39–62 years at baseline.Main Outcome MeasureChange in LDL-cholesterol concentrations between the baseline (1991–3) and follow-up (2003–4).ResultsMean 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<0.001); among those who improved their diet—especially the ratio of white to red meat consumption and the ratio of polyunsaturated to saturated fatty acids intake—(−0.07 mmol/l, n=717) compared with those with no change in diet (n=3071; p=0.03) and among those who increased physical activity (−0.10 mmol/l, n=601) compared with those with no change in physical activity (n=3312; p=0.005). Based on these estimates, successful implementation of lipid-lowering drug treatment for high-risk participants (n=858) and favourable changes in diet (n=3457) and physical activity (n=2190) among those with non-optimal lifestyles would reduce LDL-cholesterol by 0.90 to 1.07 mmol/l in the total cohort.ConclusionsBoth lipid-lowering pharmacotherapy and favourable changes in lifestyle independently reduced LDL-cholesterol levels in a cohort of middle-aged men and women, supporting the use of multifaceted intervention strategies for prevention.
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titleDecline in low-density lipoprotein cholesterol concentration: lipid-lowering drugs, diet, or physical activity? Evidence from the Whitehall II study
authorBouillon, Kim ; Singh-Manoux, Archana ; Jokela, Markus ; Shipley, Martin J ; Batty, G David ; Brunner, Eric J ; Sabia, Séverine ; Tabák, Adam G ; Akbaraly, Tasnime ; Ferrie, Jane E ; Kivimäki, Mika
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15Exercise
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abstractObjectiveTo 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.DesignA prospective cohort study.SettingThe Whitehall II study.Participants4469 British civil servants (72% men) aged 39–62 years at baseline.Main Outcome MeasureChange in LDL-cholesterol concentrations between the baseline (1991–3) and follow-up (2003–4).ResultsMean 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<0.001); among those who improved their diet—especially the ratio of white to red meat consumption and the ratio of polyunsaturated to saturated fatty acids intake—(−0.07 mmol/l, n=717) compared with those with no change in diet (n=3071; p=0.03) and among those who increased physical activity (−0.10 mmol/l, n=601) compared with those with no change in physical activity (n=3312; p=0.005). Based on these estimates, successful implementation of lipid-lowering drug treatment for high-risk participants (n=858) and favourable changes in diet (n=3457) and physical activity (n=2190) among those with non-optimal lifestyles would reduce LDL-cholesterol by 0.90 to 1.07 mmol/l in the total cohort.ConclusionsBoth lipid-lowering pharmacotherapy and favourable changes in lifestyle independently reduced LDL-cholesterol levels in a cohort of middle-aged men and women, supporting the use of multifaceted intervention strategies for prevention.
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pubBMJ Publishing Group Ltd and British Cardiovascular Society
pmid21487128
doi10.1136/hrt.2010.216309
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