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Cholesterol and lipids in the risk of coronary artery disease--the Framingham Heart Study
1National Heart, Lung and Blood Institute, Framingham, Massachusetts 01701.
Insights
A new US campaign will screen for coronary artery disease (CAD) risk. Low high-density lipoprotein (HDL) cholesterol is a significant risk factor, necessitating widespread cholesterol screening for heart attack prevention.
Area of Science:
- Cardiology
- Public Health
Background:
- Coronary artery disease (CAD) poses a significant public health challenge.
- Previous screening efforts focused on high blood pressure and elevated cholesterol.
- The Framingham Heart Study provides long-term data on cardiovascular risk factors.
Purpose of the Study:
- To introduce a comprehensive US campaign for identifying individuals at risk for coronary artery disease (CAD).
- To emphasize the importance of cholesterol screening for preventing heart attacks.
- To highlight the role of high-density lipoprotein (HDL) cholesterol in CAD risk assessment.
Main Methods:
- Utilizing a screening process similar to the 1970s high blood pressure campaign.
- Analyzing 35 years of data from the Framingham Heart Study.
- Evaluating the ratio of total cholesterol to HDL cholesterol as a key predictor.
Main Results:
- Elevated LDL cholesterol is not the sole indicator of CAD risk.
- Low levels of HDL cholesterol are as significant a risk factor as high LDL cholesterol.
- The total cholesterol to HDL ratio identifies approximately half of the North American population as being at risk for heart attack.
Conclusions:
- Widespread cholesterol screening is necessary for effective CAD risk management.
- Rapid cholesterol tests (under 10 minutes) facilitate population-wide screening.
- Increased awareness of individual CAD risk is achievable through accessible screening programs.
Abstract:
The USA is about to launch a massive campaign to identify those members of the population at risk for coronary artery disease (CAD). A screening process based on the high blood pressure campaign started in the 1970s aims at identifying those people with elevated cholesterol so measures can be taken to prevent fatal or nonfatal heart attacks. Data from 35 years of the Framingham Heart Study have shown that factors other than total or low density lipoprotein (LDL) cholesterol must be considered when evaluating CAD risk. In fact low levels of high density lipoprotein (HDL) cholesterol are as much a risk factor for CAD as high LDL cholesterol. The best simple test for predicting CAD is the ratio of total:HDL cholesterol and using this criterion, approximately half the population of North America is at risk for heart attack. This highlights the necessity for a screening program of cholesterol levels, and as there are tests available which can measure cholesterol in under 10 mins, the time should soon be here that everyone knows their CAD risk.