Related Experiment Videos
Relationship between plasma cholesterol and coronary artery disease in Asians
L O Hughes1, A P Wojciechowski, E B Raftery
1Department of Cardiology and Division of Clinical Sciences, Northwick Park Hospital, Harrow, Middlesex, U.K.
Insights
The cholesterol ratio, not just total cholesterol, is a key predictor of heart attack risk, especially across different ethnic groups. This finding suggests a more nuanced approach to assessing cardiovascular risk in diverse populations.
Area of Science:
- Cardiovascular Medicine
- Lipid Metabolism
- Ethnic Health Disparities
Background:
- Elevated cholesterol levels are a known risk factor for myocardial infarction (MI).
- Ethnic variations in cholesterol metabolism and cardiovascular disease (CVD) risk are increasingly recognized.
Purpose of the Study:
- To investigate the relationship between lipid profiles, including cholesterol and high-density lipoprotein (HDL) cholesterol, and MI risk in different ethnic groups.
- To determine if the ratio of total cholesterol to HDL cholesterol is a better predictor of cardiac risk across ethnic lines.
Main Methods:
- Lipid profiles (total cholesterol, HDL cholesterol, triglycerides) were measured in male MI survivors and healthy controls.
- Participants were stratified by ethnicity (White and Asian).
- Coronary atheroma extent was assessed using arteriography in Asian patients.
Main Results:
- Total cholesterol was higher in White individuals than in Asians, and higher in patients than controls.
- The cholesterol to HDL cholesterol ratio was significantly higher in MI patients.
- In Asian men, total cholesterol correlated with coronary atheroma extent, and MI risk increased with the total to HDL cholesterol ratio.
Conclusions:
- The cholesterol to HDL cholesterol ratio is a powerful independent predictor of MI, potentially more informative than total cholesterol alone, especially for inter-ethnic comparisons.
- Lower total cholesterol levels in Asian men may mask a higher cardiac risk, highlighting the importance of the cholesterol ratio.
- Assessing cardiac risk requires consideration of ethnic background and utilizing lipid ratios for more accurate comparisons.
Abstract:
Cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride concentrations were measured in 150 male survivors of first myocardial infarction and in 115 age and ethnic matched healthy controls. The total cholesterol concentration was higher in whites than in respective Asian groups and higher in patients than in controls (P less than 0.001). The ratio of cholesterol to HDL cholesterol was significantly higher in patients (P less than 0.001) and in both ethnic groups was a powerful independent predictor of cases. In Asians, the extent of coronary atheroma assessed by arteriography 2-12 weeks after infarction correlated independently with the total cholesterol concentration (P = 0.03). Thus, in Asian men, the lower level of total cholesterol compared to whites may be misleading. In Asian men the extent of atheroma correlated with the total cholesterol concentration and the relative risk of infarction increased with the ratio of total to HDL cholesterol. At a given level of cholesterol different ethnic groups may be at differing levels of cardiac risk and the cholesterol ratio may be a more appropriate means of inter-ethnic comparison.