The relation of documented coronary artery disease to levels of total cholesterol and high-density lipoprotein cholesterol.
Recommendations for identifying persons at high risk for coronary heart disease are based primarily on levels of total and low-density lipoprotein cholesterol. We examined whether, given knowledge of these levels, information on the high-density lipoprotein cholesterol level would improve the prediction of arteriographically documented coronary artery disease among 591 men. We found that even at levels of total and low-density lipoprotein cholesterol considered desirable, high-density lipoprotein cholesterol was inversely related to disease severity. For example, among the 112 men with a total cholesterol level <180 mg per dl, the mean occlusion score (representing the overall severity of disease) was 107 among men with a high-density lipoprotein cholesterol level < or = 30 mg per dl vs a mean score of 52 among men with levels > or = 45 mg per dl. Furthermore, men with low levels of both low-density lipoprotein cholesterol (< 110 mg per dl) and high-density lipoprotein cholesterol (< or = 30 mg per dl) had as much occlusive disease as did men with high levels of both lipoprotein fractions. Given information on the ratio of high-density lipoprotein cholesterol to total cholesterol, the actual levels of the lipoprotein fractions did not improve disease prediction. Our results emphasize the importance of considering high-density lipoprotein cholesterol when assessing coronary heart disease risk.
Freedman
D S
DS
Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724.
Croft
J B
JB
Anderson
A J
AJ
Byers
T
T
Jacobsen
S J
SJ
Gruchow
H W
HW
Walker
J A
JA
Barboriak
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014922:Wisconsin / Q000453:epidemiology
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol