High density lipoprotein cholesterol, total cholesterol screening, and myocardial infarction. The Framingham Study.

Abstract

The relation between high density lipoprotein cholesterol (HDL-C) and the development of myocardlal Infarction was examined In 2425 subjects, aged 50 to 79 years, who were enrolled In the Framingham Study from 1969 to 1971. After 12 years of follow-up, men in the bottom three quartiles of HDL-C (<52 mg/dl) experienced a 60% to 70% excess of myocardlal Infarction as compared to men whose HDL-C levels were higher (p<0.05). The effect of HDL-C was especially strong In women. In separate comparisons to the 4th quartlle of HDL-C (> 67 mg/dl), the risk of myocardial Infarction Increased from a fourfold excess In the adjacent 3rd quartlle (56 to 66 mg/dl, p<0.01) to a nearly sixfold excess In the 1st quartile (<46 mg/dl, p < 0.001). These results persisted after adjusting for age and other risk factors. In addition, a significant effect of HDL-C remained In subjects who had the lowest concentrations of total cholesterol (=s 192 mg/dl In men and 211 mg/dl In women) In which 29% had levels of HDL-C (s 36 mg/dl In men and 46 mg/dl In women) that were associated with a marked elevation In the Incidence of myocardlal Infarction. We conclude that screening for total cholesterol alone In men and women aged 50 and older may not adequately Identify the coronary candidate. In addition, selective screening of HDL-C only for Individuals with high concentrations of total cholesterol can leave the false Impression that low total cholesterol Is uniformly associated with a healthy risk profile. S everal epidemiologic studies have demonstrated that high density lipoprotein cholesterol (HDL-C) is inversely related to the incidence of coronary heart disease morbidity and mortality.1 " 7 Fewer studies have established a relation between HDL-C and specific coronary manifestations, including angina pectoris, coronary insufficiency, and myocardial infarction. while most fail to provide data for women. 3 " 10 In this report, a closer examination of the effect of HDL-C as a determinant of the specific manifestation of myocardial infarction is presented for men and women aged 50 and older. We describe the incidence of myocardial infarction as it occurred for various ranges of HDL-C, after adjusting for age and other cardiovascular risk factors. We further examine the effect of HDL-C within groups of subjects with low and high concentrations of total cholesterol and the resulting implications for screening for total cholesterol alone. Findings for this report are based on 12 years of follow-up of a sample of subjects originally enrolled in the Framingham Study. MethodsSince 1948, the Framingham Study has biennially followed 5209 men and women for the development of cardiovascular disease. Sampling methods, response rates, follow-up, and examination procedures have been described elsewhere.11 - 12From 1969 to 1971, fasting levels of HDL-C were first determined among study participants after heparin-manganese chloride precipitation of fresh plasma, following a modified protocol adopted by the Lipid Research Clinics. 13For this report, subjects we...

Plasma lipid, lipoprotein cholesterol, and apoprotein distributions in selected US communities. The Atherosclerosis Risk in Communities (ARIC) Study.

“…33 HDL cholesterol levels in the ARIC Study were higher in women of both races than in men, a finding well documented by other studies. 34 - 35 We report that black men have higher levels of HDL cholesterol and lower levels of triglycerides across all age strata than white men. This result is consistent with the inverse relation between fasting triglycerides and HDL cholesterol levels reported in other epidemiological studies.…”

Houttuynia cordataalleviates high-fat diet-induced non-alcoholic fatty liver in experimental rats

“…The vehicle (distilled water) used to prepare HC-EA extract was given at the same volume. Each group consists of eight rats and (Abbott et al, 1988) and that the TC/HDL-C ratio is sensitive predictors of atherosclerosis (Shanmugasundaram et al, 1986). The relatively low ratios in HFD-fed rats treated with HC-EA extract suggest that HCE might also possess anti-atherogenic potential.…”

Repeatedly heated palm kernel oil induces hyperlipidemia, atherogenic indices and hepatorenal toxicity in rats: Beneficial role of virgin coconut oil supplementation

“…The coronary risk index (CRI), atherogenic index (AI) and cardiovascular risk index (CVRI) were determined using the following formulae (Abbott et al, 1988;Alladi et al, 1989). …”