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Incidence of Coronary Heart Disease and Lipoprotein Cholesterol Levels
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1986
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HypertensionCardiometabolic RiskHyperlipidemiaPreventive CardiologyCoronary Artery DiseaseFramingham StudyTotal Cholesterol LevelsPublic HealthAtherosclerosisCardiac ImagingDyslipidemiaLipid DisorderCardiometabolic DisordersCardiovascular EpidemiologyHealth PolicyLipoprotein Cholesterol LevelsTotal CholesterolCardiovascular Disease Risk AssessmentEpidemiologyCoronary Heart DiseaseCardiovascular DiseaseCardiovascular Risk FactorsMedicine
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 levels at two time points eight years apart and incorporated them into a multivariate model adjusting for smoking, weight, alcohol, glucose, total cholesterol, and blood pressure. Over 12 years, fasting HDL‑C remained inversely associated with CHD risk, and even after adjusting for multiple risk factors, high HDL‑C and total cholesterol levels predicted lower CHD incidence, with participants at the 80th percentile of HDL‑C having half the risk compared to those at the 20th percentile. JAMA 1986;256:2835‑2838.
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. (<i>JAMA</i>1986;256:2835-2838)