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HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein phenotyping study

W P Castelli, J T Doyle, T Gordon

    Circulation
    |May 1, 1977
    PubMed

    Insights

    Lower high-density lipoprotein (HDL) cholesterol levels are linked to coronary heart disease (CHD) prevalence. This inverse association remained significant even after accounting for other lipid levels, highlighting HDL cholesterol

    Area of Science:

    • Cardiovascular Epidemiology
    • Lipid Metabolism
    • Public Health

    Background:

    • Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
    • Fasting lipid levels are established risk factors for cardiovascular diseases.
    • Understanding the specific role of different lipoprotein fractions in CHD is crucial for prevention strategies.

    Purpose of the Study:

    • To investigate the association between fasting lipid levels and the prevalence of coronary heart disease (CHD).
    • To examine these associations across diverse populations with varying ancestries and geographic locations.

    Main Methods:

    • A case-control study was conducted involving 6859 men and women aged 40 years and older.
    • Participants were drawn from five distinct populations: Albany, Framingham, Evans County, Honolulu, and San Francisco.
    • Fasting lipid levels, including high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides, were assessed and compared between cases (with CHD) and controls (without CHD).

    Main Results:

    • Mean levels of high-density lipoprotein (HDL) cholesterol were consistently lower in individuals with CHD compared to those without, across all major study groups.
    • This inverse association between HDL cholesterol and CHD prevalence was statistically significant, although the average difference was small (3-4 mg/dl).
    • The inverse HDL cholesterol-CHD relationship persisted even after adjusting for levels of low-density lipoprotein (LDL) cholesterol and triglycerides, while direct relationships between LDL cholesterol, total cholesterol, and triglycerides with CHD were less consistently observed across study groups.

    Conclusions:

    • Lower levels of high-density lipoprotein (HDL) cholesterol are significantly associated with an increased prevalence of coronary heart disease (CHD).
    • This inverse relationship is a robust finding, independent of other major lipid risk factors like LDL cholesterol and triglycerides.
    • The consistent inverse association of HDL cholesterol with CHD across diverse populations underscores its importance as a potential protective factor against cardiovascular disease.

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