BACKGROUND:Chlamydia pneumoniae infection has been linked to the development of coronary heart disease (CHD), but its relationship to CHD risk factors is less clear. OBJECTIVE: To determine the relationship between past infection with C. pneumoniae and risk factors for CHD, including body weight amongst subjects with and without CHD. METHODS: Antibodies to C. pneumoniae and a range of CHD risk factors were determined in 170 subjects, of whom 43 had recent onset angina. Anthropometric, haemodynamic, lipid and metabolic measurements were obtained and related to antibody status in univariate and multivariate analyses. RESULTS: IgG seropositive (n ¼ 62) did not differ from seronegative subjects in age but were significantly heavier (26.6 AE 0.4 vs 25.5 AE 0.3 kg=m 2 , P ¼ 0.02). The prevalence of seropositivity was similar for subjects with and without CHD and for those with or without hypertension. Subjects with fasting insulin levels greater and those with LDL diameters below the median also had a significantly higher prevalence of seropositivity (45.3 vs 27.3%, P ¼ 0.015 and 45.0 vs 29.4%, P ¼ 0.045 respectively). However in multivariate analysis only body mass index remained significant (P < 0.05). Results were not explained by differences in socioeconomic class. CONCLUSION: Although the study has failed to find a greater prevalence of antibodies to C. pneumoniae amongst subjects with recent onset angina there were associations with a number of cardiovascular risk factors. An increase in body weight appears to underlie these relationships.

Background: Structured lipids are being incorporated into foods to reduce their energy value. One such lipid is rich in stearic acid. Objective: The objective of this study was to compare the effects on plasma lipids of a stearic acid-rich triacylglycerol and a fat rich in palmitic acid in hypercholesterolemic subjects. Design: Fifteen subjects with an average plasma cholesterol concentration of 6.13 ± 0.80 mmol/L initially ate a low-fat diet for 2 wk (run-in period), followed in random order and blinded fashion by 2 high-fat diets (for 5 wk each) containing foods derived from margarines rich either in palmitic acid or in the structured, stearic acid-rich triacylglycerol. Results: Plasma cholesterol concentrations with the low-fat, the stearic acid-rich, and the palmitic acid-rich diets were not significantly different (5.35 ± 0.83, 5.41 ± 0.78, and 5.52 ± 0.68 mmol/L, respectively) but were significantly lower (P < 0.001) than those measured during the habitual diet period (ie, 2 wk before the study began). Neither HDL cholesterol nor plasma triacylglycerol differed significantly among the 3 study diets. Conclusion: A similar increase in the intake of stearic and palmitic acids (differing by Ϸ5% of total energy) to ensure a high fat intake resulted in plasma total and LDL-cholesterol concentrations that did not differ significantly from concentrations measured during a period of low-fat intake.

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Abstract:On an individual and a population basis, an increased incidence of coronary heart disease is associated with classical cardiovascular risk factors, but many cases occur in people not identified as at high risk. Conversely, many people at high statistical risk do not develop coronary disease. We used a questionnaire to identify unrecognised coronary heart disease in people attending large-scale health survey centres. Participants were required to report the presence and characteristics of any chest pain. Those returning responses consistent with myocardial ischaemia were offered treadmill exercise ECG tests. Over 18 months, 4070 questionnaires were returned. Of 475 respondents offered testing, 229 (198 male, 131 female) accepted. Thirty-two subjects (15 male, 17 female: a detection rate of 13.9 per cent of those assessed as likely on questionnaire, or 0.8 per cent of all respondents) had results consistent with significant coronary heart disease. Follow-up was available in 30 cases. There was no difference in classical risk-factor distribution (including multivariate risk percentiles: 42.4 (male) and 46.7 (female)) between those newly diagnosed with coronary heart disease and their community counterparts. More women than men were identified as suffering from unrecognised coronary heart disease, with a preponderance of younger women. Cost per case identified was A$l220. Screening by self-administered questionnaire is a useful and relatively cost-effective means of identifjmg unrecognised coronary heart disease. (Aust N ZJPublic Health 1997; 21: 545-7) N a population basis, an increased incidence of coronary heart disease is associated with 0 higher levels of classical cardiovascular risk factors, considered to be clinical or biochemical markers of a statistically increased likelihood of having or developing the disease.' Much coronary heart disease morbidity and mortality occurs in people not classified as at excessively high risk. This is because, at least partly, of the high proportion of the population who fall into the mild-to-moderate-risk group and to the complex multifactorial interactions involved in the development of coronary heart disease. Population screening on the basis of classical risk factors is therefore likely to miss a significant number of people who warrant further investigation Correspondence to Dr

On an individual and a population basis, an increased incidence of coronary heart disease is associated with classical cardiovascular risk factors, but many cases occur in people not identified as at high risk. Conversely, many people at high statistical risk do not develop coronary disease. We used a questionnaire to identify unrecognised coronary heart disease in people attending large-scale health survey centres. Participants were required to report the presence and characteristics of any chest pain. Those returning responses consistent with myocardial ischaemia were offered treadmill exercise ECG tests. Over 18 months, 4070 questionnaires were returned. Of 475 respondents offered testing, 229 (198 male, 131 female) accepted. Thirty-two subjects (15 male, 17 female: a detection rate of 13.9 per cent of those assessed as likely on questionnaire, or 0.8 per cent of all respondents) had results consistent with significant coronary heart disease. Follow-up was available in 30 cases. There was no difference in classical risk-factor distribution (including multivariate risk percentiles: 42.4 (male) and 46.7 (female)) between those newly diagnosed with coronary heart disease and their community counterparts. More women than men were identified as suffering from unrecognised coronary heart disease, with a preponderance of younger women. Cost per case identified was A$l220. Screening by self-administered questionnaire is a useful and relatively cost-effective means of identifjmg unrecognised coronary heart disease. (Aust N ZJPublic Health 1997; 21: 545-7) N a population basis, an increased incidence of coronary heart disease is associated with 0 higher levels of classical cardiovascular risk factors, considered to be clinical or biochemical markers of a statistically increased likelihood of having or developing the disease.' Much coronary heart disease morbidity and mortality occurs in people not classified as at excessively high risk. This is because, at least partly, of the high proportion of the population who fall into the mild-to-moderate-risk group and to the complex multifactorial interactions involved in the development of coronary heart disease. Population screening on the basis of classical risk factors is therefore likely to miss a significant number of people who warrant further investigation Correspondence to Dr