{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:55:10Z","timestamp":1787320510141,"version":"build-2736575974"},"reference-count":32,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100000002","name":"NIH National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2017,12,29]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The residual cardiovascular disease (CVD) risk in individuals on long-term lipid-lowering treatment (LLT) in the general population is not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We estimated absolute CVD risks by age and sex for different categories of low-density lipoprotein cholesterol (LDL-C) levels, stratified by LLT status, and assessed subclinical carotid atherosclerosis in 3012 Framingham Study participants (mean age, 58.4 years; 55% women) free of CVD. Individuals were categorised into five groups: (1) LDL-C &lt;100\u2009mg\/dL without LLT; (2) LDL-C \u2265100\u2009mg\/dL to &lt;130\u2009mg\/dL without LLT; (3) LDL-C &lt;130\u2009mg\/dL on LLT; (4) LDL-C \u2265130\u2009mg\/dL without LLT; and (5) LDL-C \u2265130\u2009mg\/dL on LLT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Individuals in groups 3\u20135 had significantly more carotid atherosclerosis compared with group 1. During follow-up (median, 13.7 years), 548 CVD events occurred. Individuals on LLT (groups 3 and 5) had substantial residual CVD risk (26.7 (95% CI 19.5 to 34.0) and 24.1 (95% CI 16.2 to 31.9) per 1000 person-years, respectively), representing approximately three times the risk for untreated individuals with LDL &lt;100\u2009mg\/dL (group 1: 9.0 (95% CI 6.8 to 11.3) per 1000 person-years). Absolute CVD risks rose with age and were slightly greater in men than in women. After adjustment for traditional risk factors, groups 3\u20135 displayed increased hazards for CVD (HR=1.47, 1.42 and 1.54, respectively) compared with group 1. Further adjustment for carotid atherosclerosis modestly attenuated these results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is substantial residual CVD risk in individuals on LLT, compared with participants with optimal LDL-C (&lt;100\u2009mg\/dL), even when LDL-C levels &lt;130\u2009mg\/dL are reached.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2017-000722","type":"journal-article","created":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T20:10:34Z","timestamp":1516997434000},"page":"e000722","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Residual cardiovascular risk in individuals on lipid-lowering treatment: quantifying absolute and relative risk in the community"],"prefix":"10.1136","volume":"5","author":[{"given":"Wolfgang","family":"Lieb","sequence":"first","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts, USA"},{"name":"Institute of Epidemiology, Christian Albrechts University Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle M","family":"Enserro","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts, USA"},{"name":"Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, USA"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin G","family":"Larson","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts, USA"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramachandran S","family":"Vasan","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts, USA"},{"name":"Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, USA"},{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, 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