Prevention & lipidsResearch article
U-Shaped Lipid-CVD Links in Older Adults
- Multivariable Cox regression models and restricted cubic splines
- U.K. Biobank
Authors' conclusion
U/L-shaped associations of LDL-C and HDL-C with CVD risk in older adults underscore the importance of maintaining lipids within an optimal range. This distinct "Goldilocks zone" is associated with minimized risk and highlights current guideline limitations.
Study context
- Population
- U.K. Biobank participants aged ≥60 years, free of cardiovascular disease (CVD) and cancer at baseline
- Participants
- 217,442 U.K. Biobank participants
- Comparison
- associations of low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) levels with CVD outcome
Main finding
As reported in the abstract
CVD events during follow-up
CVDs
26,756
CVD deaths
2,726
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident CVD and CVD mortality, LDL-C Q1 — LDL-C Q1 vs reference LDL-C group · incident CVD, 39% higher | 1.39 (1.32–1.47) | |
| Incident CVD and CVD mortality, LDL-C Q1 — LDL-C Q1 vs reference LDL-C group · CVD mortality, 27% higher | 1.27 (1.08–1.48) | |
| Incident CVD and CVD mortality, HDL-C Q6 — HDL-C Q6 vs reference HDL-C group · incident CVD, lower | 0.90 (0.84–0.97) | |
| Incident CVD and CVD mortality, HDL-C Q6 — HDL-C Q6 vs reference HDL-C group · CVD mortality, higher | 1.24 (1.01–1.51) | |
| 0.512Hazard ratio (log scale) |
LDL-C and incident CVD and CVD mortality (shape)
- U-shaped relationships; minimal risk
- 3.600-4.204 mmol/L
HDL-C and incident CVD and CVD mortality (shape)
- L-shaped with incident CVD; U-shaped with CVD mortality; minimal risk
- 1.421-1.699 mmol/L
Joint LDL-C and HDL-C risk tiers
- CVD risk rose progressively with joint LDL-C and HDL-C risk tiers
Original publication
U-Shaped Lipid-CVD Links in Older Adults. JACC Adv. Published 22 January 2026. doi:10.1016/j.jacadv.2025.102544
Summarised from the published abstract; every number is checked against it