Raised lipoprotein(a) in hypercholesterolaemic black students compared to age-matched whites in North and South Carolina.
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.
Heyden
S
S
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710.
Von Eckardstein
A
A
Schulte
H
H
Schneider
K
K
Assmann
G
G
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
D008055:Lipids; D017270:Lipoprotein(a)