American Journal of Epidemiology Vol. 109, No. 3: 285-295
Copyright © 1979 by The Johns Hopkins University School of Hygiene and Public Health
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THE ASSOCIATION OF LOW LEVELS OF HDL CHOLESTEROL AND ARTERIOGRAPHICALLY DEFINED CORONARY ARTERY DISEASE1
2 Department of Epidemiology, The Johns Hopkins School of Hygiene and Public Health Baltimore, MD
3 Cardiology Division, Department of Medicine, The Johns Hopkins School of Medicine Baltimore, MD 21205
4 Lipid Research Laboratory, Departments of Medicine and Pediatrics, The Johns Hopkins School of Medicine Baltimore, MD
3Reprint requests to Dr. Bulkley at this address.
Epidemiologic studies have found associations between low levels of high density lipoprotein (HDL) cholesterol and increased risk of coronary artery disease, using myocardial infarction or angina pectoris as endpoints. However, since most studies have not correlated HDL cholesterol with the presence, severity, or location of anatomically proven coronary disease, the present study measured HDL cholesterol levels in 483 men and women undergoing coronary arteriography. Consistent and statistically significant trends of decreasing mean HDL cholesterol levels with increasing numbers of diseased coronary arteries were observed in both men and women and in younger and older age groups. Although women without coronary disease had much higher levels of HDL cholesterol than men without coronary disease, the differences between men and women with similar degrees of coronary disease were small. Low levels of HDL cholesterol were associated with left main coronary disease; patients with both triple vessel disease and left main disease had lower levels of HDL cholesterol than did patients with triple vessel disease without left main disease. These results were not explained by the possible associations of low density lipoprotein cholesterol or triglycerides with HDL cholesterol. These findings suggest that low levels of HDL cholesterol are important risk factors for the development of atherosclerosis and that they may be useful for identifying patients at high risk of certain anatomic patterns of coronary artery disease.
arteriography; arteriosclerosis; coronary; coronary disease; high density lipoproteins
1 Presented by Dr. Pearson as the Student Prize Paper at the 11th Annual Meeting of the Society for Epidemiologic Research Iowa City, IA, June 14–16, 1978.
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