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Isolated low HDL-cholesterol as an important risk factor for coronary heart disease

M Miller1, P O Kwiterovich

  • 1Lipid Research-Atherosclerosis Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.

European Heart Journal
|December 1, 1990
PubMed

Insights

Low high density lipoprotein (HDL)-cholesterol is common in patients with coronary artery disease (CAD), even with normal total cholesterol. Measuring HDL-cholesterol is crucial for all CAD patients.

Area of Science:

  • Cardiology
  • Lipid Metabolism
  • Preventive Medicine

Background:

  • Decreased high density lipoprotein (HDL)-cholesterol is linked to hypertriglyceridaemia and inherited disorders causing premature coronary heart disease (CHD).
  • Familial hypoalphalipoproteinaemia, Tangier disease, fish eye disease, and lecithin: cholesterol acyltransferase deficiency are hereditary conditions associated with low HDL-cholesterol and normal total cholesterol.
  • Secondary causes of low HDL-cholesterol levels involve conditions affecting liver metabolism.

Purpose of the Study:

  • To investigate the prevalence of low high density lipoprotein (HDL)-cholesterol in patients with coronary artery disease (CAD).
  • To determine the significance of HDL-cholesterol measurement in CAD patients, irrespective of their total cholesterol levels.

Main Methods:

  • Analysis of HDL-cholesterol levels in patients diagnosed with coronary artery disease (CAD).
  • Comparison of HDL-cholesterol levels with total cholesterol and low density lipoprotein (LDL) cholesterol levels.
  • Assessment of the incidence of isolated hypoalphalipoproteinaemia in the study cohort.

Main Results:

  • A significant proportion of patients with coronary artery disease (CAD) exhibited low high density lipoprotein (HDL)-cholesterol levels, even when total cholesterol and low density lipoprotein (LDL) cholesterol were normal.
  • Two-thirds of men and four-fifths of women with CAD had low HDL-cholesterol levels.
  • Isolated hypoalphalipoproteinaemia was found to be highly prevalent in this patient group.

Conclusions:

  • Low high density lipoprotein (HDL)-cholesterol may be more common in coronary artery disease (CAD) patients than previously recognized.
  • Routine measurement of HDL-cholesterol is recommended for all patients with CAD, regardless of their total cholesterol status.
  • Identifying low HDL-cholesterol levels can aid in risk stratification and management of cardiovascular disease.

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