Lipid and lipoprotein abnormalities in South African Indian men with myocardial infarction

The Indian (Asian) population in South Africa has a high rate of coronary artery disease. Fasting serum lipid and lipoprotein levels were measured in 620 consecutive male survivors of myocardial infarction and compared with those of 524 healthy male volunteer controls, and the presence of hypercholesterolaemia and hypertriglyceridaemia in the patient group was related to other non-lipid coronary risk factors. All survivors and controls were below age 61 years. Total cholesterol, triglyceride and low-density-lipoprotein cholesterol concentrations varied significantly with age both in patient and control groups, whereas high-density-lipoprotein (HDL) cholesterol did not vary with age in either group. Using the 90th-percentile age-adjusted values of controls for total cholesterol (7.1 mmol/l) and triglyceride (3.0 mmol/l) as cut-off points, 287 (46%) survivors were hyperlipidaemic. Hypercholesterolaemia with or without associated hypertriglyceridaemia was the commonest abnormality: 125 (20%) patients showed hypercholesterolaemia without associated hypertriglyceridaemia; 73 (12%) had both hypercholesterolaemia and hypertriglyceridaemia and 89 (14%) hypertriglyceridaemia without associated hypercholesterolaemia. The frequency of hyperlipidaemia did not vary with age. HDL cholesterol levels below 0.66 mmol/l (10th percentile) were observed in 131 (22%) survivors. Obesity was significantly more frequent among hypertriglyceridaemic survivors, whilst diabetes and hypertension were seen more frequently in survivors with combined hypercholesterolaemia and hypertriglyceridaemia. No significant difference was noted in the frequency of smoking and family history of coronary artery disease in hyperlipidaemia and normolipidaemic patients.