The Caerphilly and Speedwell Collaborative Heart Disease Studies

Abstract

Objective-To assess the rolesof plasmatriglyceride and highdensity lipoprotein (HDL) cholesterol concentrations inpredicting ischaemicheart disease. Design-Two prospectivecohort studies withcommon core protocols. Setting and participants-Both cohorts are 100%samplesofmiddleaged men. InCaerphilly the2512men were living within a defined area. InSpeedwell the2348men were registered withlocal general practitioners. Main outcome measures-Fasting bloodsampleswere taken at initial examination and plasmalipid concentrationswere measured. Major ischaemicheartdiseaseevents were assessed fromhospital notes,deathcertificates, andelectrocardiograms. Results-At first follow up, afteran average of51years inCaerphilly and3i2 years inSpeedwell, 251majorischaemic heartdisease eventshadoccurred. Men withtriglyceride concentrations inthe top20%ofthedistribution hada relative oddsvalueforischaemic heartdisease of 2-3(95%confidence interval (95%CI)1-3 to4-1)comparedwithmen inthebottom 20%,afteradjusting forbothplasma totalandHDL cholesterol, andnon-lipid riskfactors. Men inthelowest 20%ofthe distribution ofHDL cholesterol concentration had a relative oddsvalueof17 (95%CI1-0to28)comparedwiththetop 20%,afteradjustment was made for totalcholesterol and triglyceride concentrations, and non-lipid riskfactors. Theserelations were not causedby blockers, whichwere beingtakenby5% ofthemen.