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Lipids and risk of coronary heart disease. The Framingham Study
W P Castelli1, K Anderson, P W Wilson
1Framingham Heart Study, National Heart Lung, and Blood Institute, MA 01701.
Insights
Total cholesterol significantly predicts coronary heart disease (CHD) risk in women and younger men. Lipoprotein levels, especially the total cholesterol-HDL cholesterol ratio, enhance risk prediction across all ages and genders.
Area of Science:
- Cardiovascular epidemiology
- Lipid metabolism and heart disease risk
Background:
- Total cholesterol is a known risk factor for coronary heart disease (CHD).
- Understanding lipid profiles is crucial for accurate cardiovascular risk assessment.
Purpose of the Study:
- To examine the relationship between lipid levels and CHD risk in different age and gender groups.
- To evaluate the predictive power of various lipid measures, including total cholesterol, LDL, HDL, triglycerides, and their ratios, for CHD.
Main Methods:
- Statistical analysis of lipid levels and CHD incidence.
- Multivariate studies adjusting for other known risk factors.
- Age-specific analysis of lipid-associated CHD risk in men and women.
Main Results:
- Total cholesterol is significantly associated with CHD risk in women (50-79) and younger men (50-64).
- Lipoprotein levels (LDL, HDL) improve CHD risk prediction.
- The total cholesterol-HDL cholesterol ratio is a powerful predictor in women and the sole lipid predictor in older men (65-80); triglycerides are significant in women but not men.
Conclusions:
- Lipid profiles, particularly the total cholesterol-HDL cholesterol ratio, are vital for assessing CHD risk across diverse populations.
- Age and gender influence the association between lipids and CHD, with risk increasing with age.
Abstract:
Total cholesterol level is significantly related to risk of coronary heart disease (CHD), adjusting for other risk factors in women 50 to 79 years old and in men aged 50 to 64 years, at P < .001. Determining the levels of lipoproteins such as low-density-lipoprotein (LDL) cholesterol and high-density-lipoprotein (HDL) cholesterol improves the prediction of risk. Triglycerides are independently related in women at all ages but miss statistical significance in the multivariate studies in men. The total cholesterol-HDL cholesterol ratio is another powerful predictor at all ages in women and is the only lipid predictor independently related to CHD in men 65 to 80 years old. Inspection of the age-specific association of cholesterol with risk in men and women also reveals that the absolute rates of disease worsen with age.