Non-HDL cholesterol predicts coronary heart disease in primary prevention: findings from an Italian 40-69 year-old cohort in general practice.
OBJECTIVE
Non-HDL cholesterol is now recommended as an index of risk associated with combined dyslipidemia, and it has also been found useful in predicting coronary heart disease (CHD) risk in patients with diabetes. We studied the association between known CHD risk factors, enclosed non-HDL cholesterol, and a "high CHD risk condition", i.e. a "5-years CHD risk >15%" in general practice.


METHODS
We studied 4,085 40-69 year-old diabetic (no. 489) and non-diabetic (no. 3,596) individuals from an opportunistic cohort. Cross-sectional descriptive statistics, and age- and gender-adjusted multiple logistic exponential betas have been calculated.


RESULTS
About 12% of the participants had diabetes. Age- and gender-adjusted comparison showed that all the study variables were significantly worse in diabetic vs. non-diabetic individuals (except cigarette smoking, total blood cholesterol and the ratio of total to HDL cholesterol). They had a mean "5-year CHD-risk" significantly higher than non-diabetic individuals (18.8+/-11.9% vs 7.5+/-6.9%, P<0.01), and a four-fold prevalence of "5-years CHD risk >15%" (55.4% vs 11.1%, P<0.01). As to diabetic individuals, the study variables associated to a "high CHD risk condition" were cigarette smoking, systolic blood pressure, and non-HDL blood cholesterol levels. As to non-diabetic individuals cigarette smoking, systolic blood pressure, and HDL (inversely) and non-HDL blood cholesterol levels were associated to a "high CHD risk condition".


CONCLUSIONS
Non-HDL cholesterol--and cigarette smoking and systolic blood pressure--strongly predicted a "high CHD risk condition" both in diabetic and non-diabetic individuals.
Ciardullo
Anna V
AV
Local Health Plan for Cardiovascular Disease, Local Health Unit, Modena, Italy. a.ciardullo@ausl.mo.it
Azzolini
Luigi
L
Bevini
Massimo
M
Cadioli
Tiziano
T
Malavasi
Paolo
P
Morellini
Alberto
A
Daghio
M Monica
MM
Guidetti
Patrizia
P
Lorenzetti
Manuela
M
Carapezzi
Carlo
C
Bacchelli
M
M
Bellodi
C
C
Beltrami
A C
AC
Carretti
G
G
Di Fiore
A
A
Feltri
G
G
Frigani
A
A
Gaglianò
G
G
Gazzani
G
G
Loscalzo
G
G
Losi
A
A
Mantovani
L
L
Pavarotti
V
V
Prandi
B
B
Ribaldi
A
A
Rosselli
C
C
Tirelli
G
G
Veratti
M
M
Vincenzi
A
A
D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology*; D005194:Family Practice; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
D008076:Cholesterol, HDL