Low-density Lipoprotein Cholesterol and Risk of Coronary Heart Disease Among Japanese Men and Women: the Circulatory Risk in Communities Study (CIRCS)

Objective: The objective of this study was to assess the association between serum LDL-cholesterol levels and risk of coronary heart disease (CHD) among Japanese who have lower means of LDL-cholesterol than Western populations.

Methods: The predictive power of estimated serum LDL-cholesterol levels in casual blood samples for risk of CHD was evaluated among residents from four Japanese communities participating in the Circulatory Risk in Communities Study (CIRCS). A total of 8131 men and women, aged 40 to 69 years with no history of stroke or CHD, completed baseline risk factor surveys between 1975 and 1987. By 2003, 155 cases of incident CHD (myocardial infarction, angina pectoris and sudden cardiac death) had been identified.

Results: Mean LDL-cholesterol values were 99.4 mg/dL for men and 109.4 mg/dL for women. The crude incidence rate (per 100,000 person-years) of CHD was 152.0 for men and 51.9 for women. The respective multivariable hazard ratios for ≥ 140 mg/dL versus <80mg/dL LDL-cholesterol were 2.80 (95% confidence interval: 1.59 to 4.92) for total CHD, 3.83 (1.78-8.23) for myocardial infarction, 4.07 (2.02-8.20) for non-fatal CHD, and 1.24 (0.44-3.47) for fatal CHD.

Conclusion: Serum LDL-cholesterol levels ranging from around 80 mg/dL to 200mg/dL were positively associated with risk of CHD in a Japanese population.