Low triglycerides-high high-density lipoprotein cholesterol and risk of ischemic heart disease.
BACKGROUND
A high triglyceride (TG)--low high-density lipoprotein cholesterol (HDL-C) level (TG > or =1.60 mmol/L [> or =142 mg/dL] and HDL-C < or =1.18 mmol/L [< or =46 mg/dL]) is associated with a high risk of ischemic heart disease (IHD), whereas a low TG--high HDL-C level (TG < or =1.09 [< or =97 mg/dL] and HDL-C > or =1.48 mmol/L [> or =57 mg/dL]) is associated with a low risk. Conventional risk factors tend to coexist with high TG--low HDL-C levels. We tested the hypothesis that subjects with conventional risk factors would still have a low risk of IHD if they had low TG--high HDL-C levels.


METHODS
Observational cohort study of 2906 men aged 53 to 74 years free of IHD at baseline.


RESULTS
During 8 years, 229 subjects developed IHD. Stratified by conventional risk factors-low-density lipoprotein cholesterol level (< or =4.40 mmol/L or >4.40 mmol/L [< or =170 mg/dL or >170 mg/dL] [median value]), hypertensive status (blood pressure >150/100 mm Hg or taking medication), level of physical activity (>4 h/wk or < or =4 h/wk), and smoking status (nonsmokers vs smokers)-the incidence in men with high TG--low HDL-C levels was 9.8% to 12.2% in the low-risk and 12.2% to 16.4% in the high-risk strata; the corresponding values in men with low TG--high HDL-C concentrations were 4.0% to 5.1% and 3.7% to 5.3%, respectively. Based on an estimate of attributable risk, 35% of IHD might have been prevented if all subjects had had low TG--high HDL-C levels.


CONCLUSIONS
Men with conventional risk factors for IHD have a low risk of IHD if they have low TG--high HDL-C levels.
Jeppesen
J
J
The Copenhagen Male Study, Epidemiological Research Unit, Copenhagen University Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.
Hein
H O
HO
Suadicani
P
P
Gyntelberg
F
F
D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood*; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D014280:Triglycerides