Lipids and lipoproteins in symptomatic coronary heart disease: Distribution, intercorrelations, and significance for risk classification in 6,700 men and 1,500 women

U. Goldbourt, J. Agmon, S. Behar, D. Brunner, A. Caspi, E. Graff, E. Kaplinsky, Y. Kishon, H. Reicher-Reiss, J. Waysbort, Z. Schlesinger, A. Fridensohn, L. Reisin, J. Jafari, Y. Friedman, S. Sclarovsky, B. Ostfeld, E. Abinader, S. Rochfleish

Research output: Contribution to journalArticlepeer-review

71 Scopus citations

Abstract

Background. Lipid and lipoprotein profiles of coronary heart disease (CHD) patients have usually not included data on high density lipoprotein cholesterol (HDL-C), except in small groups, and have not included information on women. Both aspects are meaningful in the evaluation of patients for risk classification and for the importance of HDL-C in dictating further evaluation. Methods and Results. In the screening phase of a clinical trial, we obtained lipid and lipoprotein levels under Centers for Disease Control-standardized procedures in more than 6,700 men and 1,500 women aged 40-72 years. Mean total cholesterol (TC) was higher in women (by 15-24 mg/dl) but changed little with age. Mean HDL-C, however, progressively increased with increased age for both sexes (34.4 at age of less than 50 years to 37.5 mg/dl at age 65 or older in men and from 41.3 to 44.5 mg/dl for the respective age groups in women). Triglycerides (TG) were lower in elderly groups, particularly in men (151 mg/dl in 65-year-olds versus 189 in counterparts less than 50 years). The number of previous infarctions, severity of congestive heart failure, and severity of angina were negatively correlated with mean HDL-C in a dose-response manner, whereas the association with mean TG was inverted, creating a mirror image of that observed with HDL- C. More than half of patients (52%) with TC <200 mg/dl exhibited HDL-C levels consistent with the accepted 'high-risk' range of <35 mg/dl, whereas an increasing percentage of desirable HDL-C level was found with increasing levels of TC (14% with HDL-C ≥45 mg/dl at TC <200 mg/dl increasing gradually to 28% in patients with TC >260 mg/dl). Conclusions. These results provide previously unavailable information on the lipid profile of female patients and appear to strongly establish the case for obtaining all three standard blood lipid determinations (TC, HDL-C, and TG) in coronary patients as well as in the framework of detecting and classifying individuals at high risk for CHD.

Original languageEnglish
Pages (from-to)839-848
Number of pages10
JournalCirculation
Volume86
Issue number3
DOIs
StatePublished - 1 Jan 1992
Externally publishedYes

Keywords

  • clinical trials
  • coronary heart disease
  • high density lipoproteins
  • lipoproteins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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