Aim: The aim of this study was to identify the threshold level for non-high-density lipoprotein cholesterol (non-HDL-cholesterol) to raise the risk of coronary heart disease (CHD) incidence in a Japanese general population.
Methods: A total of 8,132 men and women, aged 40 to 69 years with no history of stroke or CHD, completed the baseline risk factor surveys between 1975 and 1987. Systematic surveillance of cardiovascular disease incidence was performed through 2003 (the median follow-up period was 21.9 years), and 155 incidents of CHD were identified.
Results: We found a statistically significant association between non-HDL-cholesterol levels and the risk of CHD with a threshold around 140 mg/dL. After adjustment for potential confounding factors, this association did not change materially. The multivariable hazard ratio of CHD compared with that for levels of < 100 mg/dL was 2.49 (95% confidence interval: 1.35 to 4.61) for 140-159 mg/dL and 3.13 (1.58-6.21) for ≥ 180 mg/dL. Setting the cut-off point at ≥ 140 mg/dL non-HDL-cholesterol resulted in the greatest improvement of integrated discrimination.
Conclusions: Higher concentrations of non-HDL-cholesterol are associated with an increased risk of CHD with a threshold around 140 mg/dL, suggesting that the optimal cut-off point for healthy per-sons to prevent increasing the risk of CHD might be around 140 mg/dL non-HDL-cholesterol.