ABSTRACT
Objective To evaluate the association between serum HDL-C and the risk of cardiovascular diseases(CHD) in subjects aged 35-64 years. Methods A prospective study was carried out in 11 provinces from 1992 to 2002. The association of baseline HDL-C level and cardiovascular disease occurrence was analyzed in 30384 subjects aged 35-64 years using Cox multivariate proportional hazards regression. Results (1) Compared with the group of HDL-C≥1.56 mmol/L, multivariate-adjusted relative risk of ischemic cardiovascular disease(ICVD), including CHD and ischemic stroke increased continuously with decreased HDL-C level. (2)HDL-C level had different impact on different types of CVD.Positive association was observed between HDL-C level and the risk of ischemic stroke,but the relationship between HDL-C level and the risk of hemorrhagic stroke was indefinite. Compared with the group with HDL-C≥1.56 mmol/L,the risk of CHD of the group with HDL-C≤1.03 mmol/L increased by 45%(RR=1.45,P＜0.05)and that of ischemic stroke increased by 53%(RR=1.53,P＜0.01).(3)6.4% of ICVD,7.2% of the acute CHD and 7.3% of the acute stroke was attributable to low serum high density lipoprotein cholesterol. Conclusions Starting from HDL-C≥1.56 mmol/L, the risk of ICVD increasescontinuously with decreased HDL-C level. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce theoverall risk of CVD.
ABSTRACT
BACKGROUND AND OBJECTIVES: The aims of this study were to compare the lipid distributions and risk factors in an angiographically normal coronary artery group to those of microvascular and coronary artery diseased groups of Koreans, and to find the effects of the variable risk factors on the serum lipid levels according to the coronary atherosclerosis status. SUBJECTS AND METHODS: A total of 1,198 patients (563 males and 635 females), having undergone a coronary angiography (CAG) using Judkins method, were included. According to their coronary angiographic findings, they were divided into normal CAG (n=568), microvascular disease (n=230) and coronary atherosclerosis (n=400) groups. RESULTS: The mean value of the total cholesterol in the patients with normal coronary artery was 175 mg/dl, which progressively increased to 182 mg/dl and 198 mg/dl in the patients with microvascular disease and coronary atherosclerosis, respectively. The frequencies of the risk factors for coronary atherosclerosis also progressively increased in the patients with microvascular disease and coronary atherosclerosis. The mean values of the serum total cholesterol, LDL-cholesterol and lipoprotein(a), progressively increased from the patients with normal angiographic findings to those with microvascular disease and coronary atherosclerosis, and the results were statistically significant. The results for the patients with microvascular disease were in between those of the patients with normal angiographic findings and those with coronary atherosclerosis. CONCLUSION: The correlation between coronary atherosclerosis and the serum cholesterol levels has, until now, been studied epidemiologically, and this is the first study to angiographically elucidate the positive relationship between coronary artery disease and the serum cholesterol levels. Our data showed lower ranges of lipid distributions compared to those of the ATP III guideline.