Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham Study.

TLDR

The Framingham Study first reported an inverse relationship between high‑density lipoprotein cholesterol (HDL‑C) and coronary heart disease (CHD) incidence based on four years of surveillance. The study examined HDL‑C measured at baseline and eight years later, using both time points in a multivariate model that adjusted for smoking, weight, alcohol, glucose, total cholesterol, and blood pressure. Over 12 years, fasting HDL‑C remained inversely associated with CHD risk, and after adjustment, participants in the 80th percentile of HDL‑C had half the risk of CHD compared with those in the 20th percentile, confirming HDL‑C and total cholesterol predict CHD in men and women aged 49 and older.

Abstract

The first report from the Framingham Study that demonstrated an inverse relationship between high-density lipoprotein cholesterol (HDL-C) and the incidence of coronary heart disease (CHD) was based on four years of surveillance. These participants, aged 49 to 82 years, have now been followed up for 12 years, and this report shows that the relationship between the fasting HDL-C level and subsequent incidence of CHD does not diminish appreciably with time. Since a second measurement of HDL-C is available eight years after the initial determination, the relationship of HDL-C measurements on the same subjects at two points in time is examined. This second HDL-C measurement is also used in a multivariate model that includes cigarette smoking, relative weight, alcohol consumption, casual blood glucose, total cholesterol, and blood pressure. It is concluded that even after these adjustments, nonfasting HDL-C and total cholesterol levels are related to development of CHD in both men and women aged 49 years and older. Study participants at the 80th percentile of HDL-C were found to have half the risk of CHD developing when compared with subjects at the 20th percentile of HDL-C.