A B S T R A C T Several aspects of the effects of dietary fat on plasma lipids and lipoproteins were investigated in 12 subjects during the long-term feeding of formulas containing 40% of their calories as either saturated or unsaturated fats. The changes in fatty acid composition of plasma lipids, shown previously to occur after prolonged feedings of a dietary fat, required 10-14 days to be complete and were synchronous with the effect of the fat on plasma lipid concentrations. The change in lipid concentration occurred in low but not in high density lipoproteins. The effects on lipid levels of the low density lipoproteins were found to occur with little or no effect on the concentration of the protein moiety of these lipoproteins; as a result, cholesterol-and phospholipid to protein ratios in low density lipoproteins fell during unsaturated fat feeding. The effects of dietary fat on plasma phospholipids were studied in detail: the relative amounts of phosphatidylcholine, phosphatidylethanolamine, sphingomyelin, and lysophosphatidylcholine were unaffected by the type of dietary fat. However, the molecular species of phosphatidylcholine were markedly affected. More than 90% of the fatty acids at the a-position were saturated during both saturated and unsaturated feedings. In contrast, during unsaturated feedings, linoleate at the ,8-position outnumbered oleate by approximately 4: 1, whereas during saturated feedings these two types of fatty acids were present in nearly equal amounts.This work was presented in part at the Council on Atherosclerosis of the American Heart Association, San Francisco, Calif., 1967, and has been published in abstract form (1).

The relationship between alcohol consumption and systolic and diastolic blood pressure (BP) was examined in 2482 men and 2301 women 20 years of age or older in nine North American populations. Men at the highest level of alcohol consumption (^ 30 ml alcohol per day) had the highest BP, while women either at the highest lerel of alcohol consumption or consuming no alcohol had the highest BP. Men aged 5: 35 years of age consuming S 30 ml alcohol per day were 1.5 to 2 times more likely to be hypertensive than non-drinkers. Multivariate analysis showed systolic and diastolic BP in both men and women to be positively and significantly (p < 0.05) related to alcohol consumption, and this relationship was independent of the potential confounding effects of age, obesity, cigarette smoking, regular exercise, education, and gonadal hormone use in women. The regression coefficients indicated that an average of 30 ml of alcohol per day would produce a 2 to 6 mm Hg increase in systolic BP. Analyses suggested the univariate U-shaped alcohol-BP association in women was confounded by differences in obesity and cigarette smoking in nondrinking women, and by very low alcohol consumption in hypertensive women using medication. Additional analyses indicated that alcohol consumed in the 24 hours prior to the study was much more strongly associated with elevated BP than alcohol consumed in the week prior to the study excluding the previous 24 hours. We conclude that alcohol appears to have a modest but consistent and independent effect on systolic and diastolic BP. (Hypertension 3: 557-565, 1981) KEY WORDS • hypertension cigarette smoking eplderaiologlc studies • population studies • obesity T HERE is mounting evidence from both clinical and epidemiologic studies that alcohol consumption , especially at higher levels, is associated with elevations in blood pressure (BP), both systolic and diastolic, although the elevation in systolic BP is generally of greater magnitude. Previous studies have varied greatly in their assessment of both alcohol consumption and BP, and in their assessment of potential confounding factors that might be involved in this association. A consistent finding has been that drinkers at the highest levels of alcohol consumption show an increase in BP. 110 Other studies have shown an increase in liver function abnormalities in hypertensive patients, presumably due to increased alcohol intake. 11 ' u However, some studies have indicated certain subsets of drinkers of small or moderate amounts of alcohol had BPs no higher or even lower than non-drinkers. 1 " 8 In addition, most acute challenge studies in both animals and human subjects have shown little or no short-term effect of alcohol on BP, 1 '" 20 although positive results have been reported. 12 ' M Studies of chronic alcohol administration in animals have reported no significant long-term effect on BP. MM If alcohol can indeed raise BP, how can the nonlinear relationship in some epidemiologic studies and the uncertain results from challenge studies be explained...

A 55-year-old man with the classical mucocutaneous lesions of xanthoma disseminatum has been followed up for a period of 13 years. The special features of this case, which make it unique, are as follows: (1) the availability of histologic data on multiple lesions for more than a ten-year period; (2) the progressive nature of the multiple osseous lesions; (3) the metabolic studies that show no evidence for accumulation of abnormal sterols in a xanthoma, the blood, or intestinal aspirate; (4) the development of hypothyroidism and symptoms or signs, or both, of an intracerebral and an intraspinal lesion; (5) the partial regression of the cutanous symptoms and lesions while receiving clofibrate, in spite of progression of the mucous membrane and osseous lesions, and (6) the failure to develop diabetes insipidus to date.

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