title: Raised lipoprotein(a) in hypercholesterolaemic black students compared to age-matched whites in North and South Carolina.
abstract: BACKGROUND
  North and South Carolina are the states with the highest coronary death rates and also belong to the Stroke Belt of the US. From a Reflotron cholesterol screening in North and South Carolina schools, students with cholesterol levels > or = 4.66 mmol/l (> or = 180 mg/dl) were tested for high density lipoprotein (HDL), low density lipoprotein (LDL) and lipoprotein(a) (Lp(a)).
  
  
  METHODS
  The 923 students aged 12-19 with mild hypercholesterolaemia represented one-third of the high school population, of whom 30% are black. Of the hypercholesterolaemic white students, 96% took the additional tests, of the hypercholesterolaemic black students, 88% responded. Lp(a) levels were determined by electroimmunodiffusion.
  
  
  RESULTS
  Most important was a three-fold elevation of the geometric mean of Lp(a) values among blacks compared to whites: white males 9, white females 10, black males 25, black females 26 mg/dl, respectively, independent of age and sex. Relationships between Lp(a) and four other lipids/lipoproteins were examined and proved non-significant except for total cholesterol and LDL in black males and white females. While 70% of the white students displayed Lp(a) levels < 20 mg/dl, 65-70% of the black students showed Lp(a) levels > 20 mg/dl.
  
  
  CONCLUSIONS
  Early identification of high Lp(a) levels may be of importance for two groups, (1) black females who have a 20% higher coronary heart disease mortality rate than white females in spite of significantly higher HDL levels; and (2) for black males and black females who have a prevalence of cerebrovascular disease twice as high as in whites.
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710.
authors.forename: S
authors.initials: S
authors.lastname: Heyden
authors.forename: A
authors.initials: A
authors.lastname: Von Eckardstein
authors.forename: H
authors.initials: H
authors.lastname: Schulte
authors.forename: K
authors.initials: K
authors.lastname: Schneider
authors.forename: G
authors.initials: G
authors.lastname: Assmann
mesh_terms: D000293:Adolescent; D044383:Black People; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D015994:Incidence; D008055:Lipids / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008403:Mass Screening; D009657:North Carolina / Q000453:epidemiology; D012307:Risk Factors; D013022:South Carolina / Q000453:epidemiology; D044465:White People; D001741:Black or African American
chemical_list: D008055:Lipids; D017270:Lipoprotein(a)