{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:43:50Z","timestamp":1776401030544,"version":"3.51.2"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">It is unclear if statin therapy in midlife can restore low cardiovascular risk in hypercholesterolemic individuals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">At baseline, we grouped 5687 MESA (Multi\u2010Ethnic Study of Atherosclerosis) participants aged \u226550\u00a0years without clinical cardiovascular disease (CVD) by Adult Treatment Panel III statin treatment recommendation and statin treatment status. We used Cox regression to compare the risks for coronary heart disease and CVD between the untreated group with low\u2010density lipoprotein cholesterol (LDL\u2010C) &lt;100\u00a0mg\/dL (reference) and other groups, adjusting for CVD risk factors. We also grouped participants by LDL\u2010C level (&lt; or \u2265100\u00a0mg\/dL), coronary artery calcium score (0 or &gt;0 Agatston units), and statin status (untreated or treated) with the untreated LDL\u2010C &lt;100\u00a0mg\/dL and coronary artery calcium=0 Agatston units as the reference. There were 567 coronary heart disease and 848 CVD events over 15\u00a0years of follow\u2010up. The hazard ratios (HRs) for coronary heart disease and CVD in the group with statin\u2010treated LDL\u2010C &lt;100\u00a0mg\/dL were 1.16 (95% CI, 0.85\u20131.58) and 1.02 (95% CI, 0.78\u20131.32), respectively. However, participants with coronary artery calcium &gt;0 Agatston units, treated to LDL\u2010C &lt;100\u00a0mg\/dL had HRs of 2.6 (95% CI, 1.7\u20134.2) for coronary heart disease and 1.8 (95% CI, 1.2\u20132.6) for CVD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Individuals treated with statins to LDL\u2010C &lt;100\u00a0mg\/dL had similar levels of risk for atherosclerotic CVD as individuals with untreated LDL\u2010C &lt;100\u00a0mg\/dL. However, individuals with coronary artery calcium &gt;0 Agatston units have substantially higher risks despite lipid\u2010lowering therapy, suggesting that statin treatment in midlife may not restore a low\u2010risk state in primary prevention patients with established coronary atherosclerosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019695","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T09:39:56Z","timestamp":1621244396000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Does Lowering Low\u2010Density Lipoprotein Cholesterol With Statin Restore Low Risk in Middle\u2010Aged Adults? Analysis of the Observational MESA Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-1507","authenticated-orcid":false,"given":"Kiang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine Northwestern University, Feinberg School of Medicine Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8781-1329","authenticated-orcid":false,"given":"John T.","family":"Wilkins","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University, Feinberg School of Medicine Chicago IL"},{"name":"The Department of Medicine Division of Cardiology Northwestern University, Feinberg School of Medicine Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9322-705X","authenticated-orcid":false,"given":"Laura A.","family":"Colangelo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University, Feinberg School of Medicine Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-6110","authenticated-orcid":false,"given":"Donald M.","family":"Lloyd\u2010Jones","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University, Feinberg School of Medicine Chicago IL"},{"name":"The Department of Medicine Division of Cardiology Northwestern University, Feinberg School of Medicine Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000601"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002275"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.285122"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308537"},{"key":"e_1_3_2_7_2","first-page":"Cd004816","article-title":"Statins for the primary prevention of cardiovascular disease","author":"Taylor F","year":"2013","unstructured":"Taylor F, Huffman MD, Macedo AF, Moore TH, Burke M, Davey Smith G, Ward K, Ebrahim S. 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