Serum Lipid Levels and the Severity of Coronary and Cerebral Atherosclerosis in Adequately Nourished Men, 60 to 69 Years of Age

Paterson, James C.; Armstrong, Rosemary; Armstrong, Elizabeth C.

doi:10.1161/01.cir.27.2.229

Cited by 42 publications

(6 citation statements)

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“…Paterson et al 42 found a significant correlation between serum total cholesterol concentration and arterial plaque thickness in the basilar artery, circle of Willis, and approximately half an inch of each of the major vessels arising therefrom.…”

Section: Prospective Cohort Studiesmentioning

confidence: 99%

Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis. A review.

Tell

Crouse

Furberg

1988

Stroke

110

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Epidemiologic studies have failed to demonstrate a consistent association between blood lipid concentrations and lipoprotein abnormalities and clinical manifestations, for example, cerebral infarction. If lipids do relate to atherosclerosis, then a possible explanation for this apparent contradiction is that risk factors for symptomatic cerebrovascular disease may not necessarily be the same as those for atherosclerosis in general, that is, the factors associated with the precipitation of the clinical event may differ from those related to the underlying process of atherosclerosis. 3Because lipids are often sampled following stroke, relations, or the lack of such, between blood lipids and stroke manifestations cannot automatically be extrap-

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Section: Prospective Cohort Studiesmentioning

confidence: 99%

Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis. A review.

Tell

Crouse

Furberg

1988

Stroke

110

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“…The risk of apparently healthy individuals developing ischaemic heart disease is increased when hypercholesterolaemia is present (Kagan et al, 1962;Stamler, 1964;Truett et al, 1967). Raised plasma levels of cholesterol and triglycerides occur in many patients with angina pectoris and myocardial infarction, and in those with angina there is an association between hypercholesterolaemia and prognosis (Westlund and Nicolaysen, 1966;Frank et al, 1970) though this may not be so in patients who have had myocardial infarction (Paterson et al, 1963;Little et al, 1965;Frank et al, 1970). The benefit of controlling hyperlipidaemia either in healthy individuals (primary prevention) or in patients with ischaemic heart disease (secondary prevention) can be tested only by establishing large-scale clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Ischaemic Heart Disease: A Secondary Prevention Trial Using Clofibrate

1971

BMJ

211

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“…The only other attempt to relate the degree of coronary artery disease at necropsy with the serum lipid levels was made by Paterson, Armstrong, and Armstrong (1963) who after a meticulous study failed to establish any correlation between these variables. Many factors, including differences in methods of assessing disease severity, the selection of cases, and even the number of cases studied could singly, or in combination, account for the different findings.…”

Section: Discussionmentioning

confidence: 99%

Coronary disease severity at necropsy.

Schwartz¹,

Stenhouse²,

Taylor³

et al. 1965

Heart

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One of the most objective clinical manifestations of coronary disease is cardiac infarction. Two main pathological processes may be implicated in its pathogenesis: first, the degree of disease in the vessel wall, and secondly, the presence of disease within the arterial lumen in the form of an occluding thrombus. Because of this potentially dual pathogenesis, there is a distinct possibility that any of the lipid abnormalities associated with the development of cardiac infarction, e.g. a high serum cholesterol level, could be relevant either to the degree of disease in the vessel wall, or alternatively to thrombosis itself, for occluding or near-occluding thrombi are found in over 90 per cent of recent infarcts (Mitchell and Schwartz, 1963). We have, therefore, made an attempt to assess the relationships between the amount of the various macroscopic types of coronary artery disease and age, diastolic blood pressure, heart weight, post-mortem serum cholesterol, and total coronary artery area. These findings are presented and discussed. SUBJECTS AND METHODSDuring the years 1962-63 we studied the coronary arteries of 206 patients (122 male, 84 female) dying in the Royal Adelaide Hospital, South Australia. This unselected necropsy sample initially comprised all cases including traumatic deaths presenting for necropsy examination on Wednesdays and alternate Sundays, but throughout the latter part of the study consecutive patients were admitted to the series. For each of these patients, the age, sex, and blood pressure levels were abstracted from the hospital in-patient notes when available. Wherever there was doubt as to the validity of the pressure records thus obtained, as in cases with heemorrhage, cardiac infarction, or strokes, an attempt was made to detennine representative values from either the hospital out-patient notes, or from the patients' private medical attendants. In 15 of the 206 patients, valid pressure records were not available from the above sources.Post-mortem Serum Cholesterol. Total serum cholesterol was determined using modifications of the methods of Zlatkis, Zak, and Boyle (1953), and Zak (1957). A standard volume of serum (0X2 ml.) was heatextracted with an alcohol-acetone mixture and aliquots of this extract were evaporated to dryness. This residue was dissolved in glacial acetic acid, and the colour developed by the addition of a mixture of ferric chloride in sulphuric acid. Blood was removed from the heart while in situ with a 20 ml. syringe inserted in the right atrium, care being taken to avoid any dilution of the blood with serous fluid from the pleural or pericardial cavities. In 5 of the 206 patients the blood became gelatinous and would not separate on centrifugation.Fifteen of the 206 patients had a previous serum cholesterol estimation, at intervals ranging from several hours to two years before death. In Fig. 1, these ante-and post-mortem cholesterol levels are compared. The post-mortem levels are on the average 33 mg./100 ml. higher than the ante-mortem levels, and the cor-*

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Serum Lipid Levels and the Severity of Coronary and Cerebral Atherosclerosis in Adequately Nourished Men, 60 to 69 Years of Age

Cited by 42 publications

References 1 publication

Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis. A review.

Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis. A review.

Ischaemic Heart Disease: A Secondary Prevention Trial Using Clofibrate

Coronary disease severity at necropsy.

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