Circulation, Vol 86, 839-848, Copyright © 1992 by American Heart Association
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 less
than 200 mg/dl exhibited HDL-C levels consistent with the accepted
"high-risk" range of less than 35 mg/dl, whereas an increasing percentage
of desirable HDL-C level was found with increasing levels of TC (14% with
HDL-C greater than or equal to 45 mg/dl at TC less than 200 mg/dl
increasing gradually to 28% in patients with TC greater than 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.
ARTICLES
Lipids and lipoproteins in symptomatic coronary heart disease. Distribution, intercorrelations, and significance for risk classification in 6,700 men and 1,500 women. The Bezafibrate Infarction Prevention (BIP) Study Group, Israel
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