One cholesterol equation is most strongly linked to heart risk
Elevated cholesterol estimated by the Martin-Hopkins equation had a hazard ratio of 1.69 for heart disease, compared with 1.52 for Sampson and 1.47 for Friedewald.
Limit: Cholesterol levels were calculated from formulas rather than measured in blood tests
Edited by Boris Djordjevic · AgingResearch.News
In an observational study, researchers tracked 10,550 young adults from seven cohorts in the US, Finland, and Australia. They estimated low-density lipoprotein cholesterol, a blood fat that builds up in arteries, using three equations: Friedewald, Martin-Hopkins, and Sampson. Medical records identified 376 fatal and nonfatal cardiovascular events over an average follow-up of 22.7 years.
Elevated cholesterol was linked to cardiovascular disease across all three equations, but Martin-Hopkins showed the strongest link. It produced a hazard ratio of 1.69, compared with 1.52 for Sampson and 1.47 for Friedewald. When Sampson classified cholesterol as normal but Martin-Hopkins classified it as elevated, participants had a hazard ratio of 3.94 for cardiovascular disease. The opposite disagreement showed no increased risk, and the range of likely values included no difference. The findings were replicated in an independent middle-aged cohort from the UK Biobank.
Why it matters
Atherosclerotic cardiovascular disease develops over decades as blood vessels age, making early risk assessment vital for long-term vascular health. More accurate cholesterol formulas in early adulthood may help identify people at risk decades before cardiovascular disease emerges.
Caveats
As an observational study, the analysis links estimated cholesterol to cardiovascular outcomes but cannot show that altering treatment based on these formulas improves health. In addition, cholesterol levels were calculated from formulas rather than measured in blood tests, and the findings were reported in a conference abstract.
