HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein phenotyping study.

Abstract

SUMMARYThe relation between coronary heart disease (CHD) prevalence and fasting lipid levels was assessed by a case-control study in five populations with a total of 6859 men and women of black, Japanese and white ancestry drawn from subjects aged 40 years and older from populations in Albany, Framingham, Evans County, Honolulu and San Francisco.In each major study group mean levels of high density lipoprotein (HDL) cholesterol were lower in persons with CHD than in those DURING THE PAST TWO DECADES considerable progress has been made delineating the role of the plasma lipoproteins in the development of coronary heart disease (CHD). Interest has focused chiefly on the very low density and low density lipoproteins (VLDL and LDL); there has been relatively little interest in the role of the high density lipoproteins (HDL), which ordinarily carry about 20% of the total plasma cholesterol. (In electrophoretic terms, HDL and LDL correspond to alpha and beta, while VLDL corresponds to prebeta.) The neglect of HDL cholesterol is curious since as early as 1951 Barr et al. reported that healthy men had higher levels of alpha (or high density) lipoprotein than did men with CHD.1 This early observation was confirmed in subsequent cross-sectional studies;2-7 moreover, women, who have less CHD than men, were noted to have higher levels of this lipoprotein.5The Cooperative Lipoprotein Phenotyping Study of subjects drawn from epidemiologic studies of five diverse populations provides an excellent data base for examining the role of the various lipid fractions in coronary heart disease. In this report fasting levels of HDL, LDL and total cholesterol, and triglyceride are related to CHD prevalence. MethodsData from five study populations participating in the Cooperative Lipoprotein Phenotyping Study served as the basis for this report. The overall design and methods of these studies, all of which were derived from ongoing prospective studies of cardiovascular disease, have been described previously.""' Briefly they were: a population of male Civil without the disease. The average difference was small -typically 3-4 mg/dl -but statistically significant. It was found in most agerace-sex specific groups. The inverse HDL cholesterol-CHD association was not appreciably diminished when adjusted for levels of low density lipoprotein (LDL) cholesterol and triglyceride. LDL, total cholesterol and triglycerides were directly related to CHD prevalence; surprisingly, these findings were less uniformly present in the various study groups than the inverse HDL cholesterol-CHD association.Service employees in Albany, New York; a general population of black and white men and women in Evans County, Georgia; a general population of men and women in Framingham, Massachusetts; and general populations of men of Japanese ancestry living in Honolulu and San Francisco. In Albany and Framingham entire cohorts were invited to participate in the Cooperative Lipoprotein Phenotyping Study. The other three studies invited only random samples of their total st...

Prehypertension in disease-free adults: a marker for an adverse cardiometabolic risk profile

“…All these (larger WC, increased TGs and FSG, along with lower HDL-C levels), in addition to being the components and the criteria for the diagnosis for the metabolic syndrome, 11 are also well-established markers for increased CVD risk. [3][4][5][6][7][8][9] The prevalence of two or more disordered cardiometabolic risk factors other than high BP was significantly higher in adults with PreHTN. The fact that subjects with hypertension significantly differ from those with desirable BP (normotension) in BMI, WC, FSG, hemoglobin A1c, total-C, LDL-C, whereas the subjects with PreHTN differ significantly from those with normotension in BMI, WC, FSG, hemoglobin A1c, Insulin, homeostasis model assessment, C-reactive protein, total-C, LDL-C, TG and cardiac risk ratios attests to PreHTN being strongly associated with an adverse cardiometabolic risk profile.…”

“…[3][4][5] Higher levels of serum triglycerides (TGs) (4150 mg per 100 ml) and low levels of high-density lipoprotein-cholesterol (HDL-C) (o40 mg per 100 ml in men and o50 mg per 100 ml in women) have been similarly associated with elevated risk for vascular events. [6][7][8] Fasting serum glucose (FSG) levels over 100 mg per 100 ml increase the risk for developing cardiovascular disease (CVD). 9 Prediabetes (American Diabetes Association criteria: fasting blood glucose 100-125 mg per 100 ml and/or 2 h post-meal blood glucose 140-199 mg per 100 ml) is associated with abnormal circadian BP variability, 10 a plausible functional measure of the mechanism underlying increased adverse cardiovascular events.…”

“…We investigated the differences in otherwise healthy disease-free adults with PreHTN vs. normotension with respect to WC (4102 cm in men and 488 cm in women), TGs (4150 mg per 100 ml), HDL-C (o40 mg per 100 ml in men and o50 mg per 100 ml in women) and FSG (4100 mg per 100 ml). These qualifiers, besides each having widespread recognition in the literature for independently elevating CVD risk in otherwise healthy subjects, [3][4][5][6][7][8][9][10] are the components of the metabolic syndrome. 16 In this cross-sectional survey of the population, evidence of a link between PreHTN and the metabolic syndrome also provides an indirect evidence of increased CVD risk.…”

Association of plasma triglyceride and C-peptide with coronary heart disease in Japanese-American men with a high prevalence of glucose intolerance

“…Numerous studies examining the general population have documented the association of coronary heart disease with low HDL and HDL2 cholesterol levels [45,46]. Studies examining populations of diabetic subjects have also demonstrated the association of low HDL and HDL2 cholesterol levels with coronary heart disease [16,47,48].…”

Plasma lipoprotein patterns in patients hospitalized for coronary artery bypass surgery

“…This paper presents a relatively simple method for measuring serum HDL:LDL lipid ratios and evaluates the usefulness of this method as a predictive indicator for risk of CHD, which has been correlated positively with serum LDL-cholesterol levels (Miller and Miller, 1975;Rhoads et al, 1976) and negatively with HDL-cholesterol (Carlson and Ericsson, 1975;Castelli et al, 1977;Miller et al. 1976).…”