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

Bouillon, Kim; Singh-Manoux, Archana; Jokela, Markus; Shipley, Martin J.; Batty, G. David; Brunner, Eric J.; Sabia, S⇔(c)verine; Tabák, Adam G.; Akbaraly, Tasnime; Ferrie, Jane E.; Kivimäki, Mika
June 2011
Heart;Jun2011, Vol. 97 Issue 11, p923
Academic Journal
Objective To 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. Design A prospective cohort study. Setting The Whitehall II study. Participants 4469 British civil servants (72% men) aged 39-62⇔ years at baseline. Main Outcome Measure Change in LDL-cholesterol concentrations between the baseline (1991-3) and follow-up (2003-4). Results Mean 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. Conclusions Both 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.


Related Articles

  • NPC1L1 haplotype is associated with inter-individual variation in plasma low-density lipoprotein response to ezetimibe. Hegele, Robert A.; Guy, Justin; Ban, Matthew R.; Wang, Jian // Lipids in Health & Disease;2005, Vol. 4, p1 

    Background: NPC1L1 encodes a putative intestinal sterol transporter which is the likely target for ezetimibe, a new type of lipid-lowering medication. We previously reported rare non-synonymous mutations in NPC1L1 in an individual who had no plasma lipoprotein response to ezetimibe. We next...

  • Hronična inflamacija, lipidski faktori rizika i mortalitet kod funkcijski nesamostalnih starih osoba. Vasović, Olga; Trifunović, Danijela; Despotović, Nebojša; Milošević, Dragoslav P. // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Jul2010, Vol. 67 Issue 7, p562 

    Background/Aim. It has been proved that a highly sensitive C-reactive protein (hsCRP) can be used as an established marker of chronic inflammation for cardiovascular risk assessment. Since mean values of both low-density cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C)...

  • Lipid-Lowering Drugs Acting at the Level of the Gastrointestinal Tract. Filippatos, T. D.; Mikhailidis, D. P. // Current Pharmaceutical Design;2/11/2009, Vol. 15 Issue 5, p490 

    This review considers the hypolipidaemic drugs that act on the gastrointestinal (GI) tract. We searched PubMed up to April 2008 and included randomized controlled trials, original papers, review articles and case reports. Bile acid sequestrants (BAS) have a well-established low density...

  • Assessment of relationship between physical activity volume and blood lipids concentration in Hamedanian middle age men. Jalili, M.; Nazem, F.; Heydarianpour, A. // Iranian South Medical Journal;2012, Vol. 15 Issue 2, p109 

    Background: Inactivity is a leading contributor to chronic health problems. Physical activity (PA) is an important element in maintaining the health and functional ability in the population and has favorable effects on lipid profile in adults. Here, we examined the effects of pedometer-based PA...

  • Beef For February's American Heart Health Month. Radke, Amanda // Beef Expert Blog;1/24/2012, p5 

    The article discusses a research study for heart-healthy diet called "Beef in Optimal Lean Diet (BOLD)." It references a study that was published in the "American Journal of Clinical Nutrition" on 36 men and women with high low-density protein (LDL) cholesterol and healthy subjects who were...

  • ALTERNATIVES TO STATINS.  // Mayo Clinic Women's Health Source;Mar2007, Vol. 11 Issue 3, p1 

    The article presents nonprescription alternatives for lower density lipoprotein (LDL) cholesterol. Diet and exercise are important in lowering cholesterol level. Regular exercise can maintain healthy weight and boost good cholesterol levels. To keep LDL low, calorie intake should not exceed 200...

  • Novel Hypolipidemic Agents: the Role of PCSK9 Inhibitors. Skoumas, Ioannis N. // Hospital Chronicles;2014 Supplement 1, Vol. 9, p129 

    Hyperlipidemia is a major cause of cardiovascular disease despite the availability of first-line cholesterol lowering agents such as statins. Although statin therapy is very efficient to reduce cholesterol, nearly 10-20% of individuals on statins, experience side effects, such myopathy, which...

  • Lowering LDL plays only a part in preventing heart disease. Lenfant, Claude; Gotto, Antonio; Shepherd, James; Kwiterovich, Peter; Scanu, Angelo; Superko, Robert // Modern Medicine;Dec97, Vol. 65 Issue 12, p14 

    Presents highlights of a round-table discussion on different aspects of lipid-regulating therapy beyond low-density-lipoprotein (LDL) reduction. Benefits of LDL reduction; Effect of the presence of high levels of high density lipoprotein (HDL) and apolipoprotein apo A-1 on LDL oxidation;...

  • Assessment of Lipid Lowering Methanolic Extract in Experimeruaiiy muuueu Rnvh Text to Clipboard: English; French; Italian; Portuguese; Portuguese (Brazilian); í nypempraemra. Patel, D. K.; Patel, K. A.; Patel, U. K.; Thounaojam, M. C.; Jadeja, R. N.; Padate, G. S.; Salunke, S. P.; Devkar, R. V.; Ramachandran, A. V. // Journal of Young Pharmacists;2009, Vol. 1 Issue 3, p233 

    This inventory scrutinizes the effect of methanolic extract of Sida rhomboidea.Roxb (SR) on high fat diet-induced hyperlipidemia in male Charles foster rats. The changes in body weight, food and water intake, feed efficiency ratio and whole weight of liver and epididymal fat pad were recorded in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics