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Related Experiment Videos

Epidemiologic aspects of lipid abnormalities

M H Criqui1, B A Golomb

  • 1University of California, San Diego, Department of Family and Preventive Medicine, La Jolla 92093-0607, USA.

The American Journal of Medicine
|August 26, 1998
PubMed
Summary

The total cholesterol to high-density lipoprotein cholesterol ratio is the best predictor of cardiovascular disease risk and treatment benefit. This ratio should be emphasized more in research and patient monitoring for dyslipidemia.

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Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Epidemiology

Background:

  • Current cardiovascular disease guidelines prioritize total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol.
  • High-density lipoprotein (HDL) cholesterol and triglycerides play lesser roles in current lipid management strategies.

Purpose of the Study:

  • To review epidemiologic evidence on the independent predictive value of various lipid factors for cardiovascular disease (CVD).
  • To evaluate the predictive power of TC, LDL, HDL, very-low-density lipoprotein (VLDL) cholesterol, triglycerides, LDL particle size, and the TC/HDL ratio.

Main Methods:

  • Review of existing epidemiologic evidence on lipid factors and CVD risk.
  • Analysis of the independent predictive value of individual lipid parameters and ratios.

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  • Assessment of predictive value in relation to outcomes and treatment benefits.

    • Main Results:

    • Triglycerides are an independent CVD risk factor in certain populations; postprandial triglycerides may be more predictive than fasting levels.
    • LDL particle size lacks independent predictive value when adjusted for triglycerides.
    • The TC/HDL-cholesterol ratio is the single most predictive lipid factor for CVD risk and treatment benefit, maintaining its value into older age.

    Conclusions:

    • The TC/HDL-cholesterol ratio offers superior predictive value for cardiovascular risk and treatment response compared to other lipid parameters.
    • Increased emphasis on the TC/HDL-cholesterol ratio is recommended for epidemiologic studies and patient monitoring in dyslipidemia management.