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Cholesterol and triglyceride levels in midlife and risk of heart failure in women, a longitudinal study: the prospective population study of women in Gothenburg
  1. Anna-Karin Halldin1,
  2. Lauren Lissner2,
  3. Bodil Lernfelt3,
  4. Cecilia Björkelund1
  1. 1Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
  2. 2School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
  3. 3Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
  1. Correspondence to Dr Anna-Karin Halldin; anna-karin.halldin{at}


Objective To examine the association between triglycerides and cholesterol serum values and risk of developing heart failure in women.

Design Longitudinal observational study of four cohorts 50-year-old women examined in 1968–1969, 1980–1981, 1992–1993 and 2004–2005, and followed until 2012. S-triglycerides and s-cholesterol were measured at baseline and heart failure morbidity and mortality data collected from 1980 to 2012.

Setting Prospective population study Gothenburg, Sweden. Primary care.

Participants 1143 women 50 year old without history of heart failure or myocardial infarction.

Main outcome measure Association among s-triglycerides, s-cholesterol and heart failure expressed as HR for heart failure, adjusted for smoking, body mass index (BMI), physical activity and age.

Results For 50-year-old women examined in 1968–1969, there was an independent association between level of s-triglycerides and heart failure and a significantly higher risk of developing heart failure (HR 1.8; CI 1.16 to 2.80, for each increment of 1.0 mmol/L in s-triglycerides), adjusted for smoking, BMI, physical activity and age. There was no significant association between s-cholesterol and risk of heart failure (HR 0.9; CI 0.77 to 1.15). In the cohorts of 50-year-old women examined in 1980 and 1992, there were no significant associations between neither s-triglycerides or s-cholesterol and the risk of heart failure. In the pooled analyses of the cohorts examined in 1968, 1980 and 1992, a significantly increased risk of heart failure was found (HR 1.49; CI 1.10 to 2.03) for s-triglycerides independently, but not for s-cholesterol. None of the 50-year-old women examined in 2004–2005 developed heart failure by 2012 and were excluded from further analyses.

Conclusions High levels of s-triglycerides but not s-cholesterol may be a risk marker for later development of heart failure in 50-year-old women.

  • heart failure
  • primary care
  • adult cardiology

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  • Contributors All authors participated in the planning of the study, monitored data, drafted and revised the paper. All authors had full access to all of the study data and take responsibility for the integrity and accuracy of the data. All authors have read and approved the final version of the paper. Guarantor of the article CB accepts full responsibility for the work and the conduct of the study, had access to the data and controlled the decision to publish.

  • Funding This work was supported by grants from the Swedish Council for Health, Working Life and Welfare—FORTE (EpiLife 2006-1506, WISH 2007-1958) and by grants from the Swedish state under the agreement between the Swedish government and the country councils, the ALF-agreement (68771 and 30411).

  • Disclaimer The study sponsors had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The researchers were independent from funders. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval for the study has been obtained from the ethical review board of Gothenburg University/Regional ethical review board, diary no 65-80, 179-92, Ö 402-99, T 257-00. The participants gave informed consent before taking part. The guarantor of the manuscript (last author) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as originally planned have been explained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The datasets generated during and/or analysed during the current study are not publicly available due to Swedish law, but are available from the corresponding author on reasonable request.