Document Detail

Cholesterol and coronary heart disease: predicting risks in men by changes in levels and ratios.
MedLine Citation:
PMID:  8528755     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Little is known about the relative ability of different measures of change in cholesterol to discriminate coronary heart disease risk. We evaluated this ability for changes in low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, LDL/HDL ratios, and total cholesterol/HDL ratios. METHODS: We predicted risks of coronary heart disease using data from 3641 men in the Lipid Research Clinics Coronary Primary Prevention Trial. Treating these patients as a cohort, we estimated risks associated with changes in cholesterol levels independent of the patients' randomization group. RESULTS: Changes in LDL and HDL cholesterol when used in combination were each significant predictors of coronary heart disease risk (odds ratios [OR] for 10% increases, 1.15 and 0.84, respectively; P < 0.001). Changes in LDL/HDL and total cholesterol/HDL ratios had similar discriminating ability (OR for 10% increases, 1.17 and 1.21, respectively; P < 0.0001). In the best discriminating models, changes in ratios added information about risks to changes in LDL cholesterol, although changes in LDL cholesterol levels failed to add information to changes in ratios. CONCLUSIONS: Changes in total cholesterol/HDL and LDL/HDL ratios were better predictors of risk for coronary heart disease than were changes in LDL cholesterol levels alone. When assessed as percentage changes averaged during the first two months of intervention, they were among the best discriminators of risk. Clinicians selecting treatments for intervention should include among their considerations the treatment's effect on both LDL and HDL cholesterol rather than their effects on LDL cholesterol levels alone.
B Kinosian; H Glick; L Preiss; K L Puder
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of investigative medicine : the official publication of the American Federation for Clinical Research     Volume:  43     ISSN:  1081-5589     ISO Abbreviation:  J. Investig. Med.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1996-01-26     Completed Date:  1996-01-26     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9501229     Medline TA:  J Investig Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  443-50     Citation Subset:  IM    
University of Pennsylvania, Philadelphia 19104, USA.
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MeSH Terms
Cholesterol / blood*
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Coronary Disease / etiology*
Middle Aged
Risk Factors
Grant Support
R29-AG09837-08/AG/NIA NIH HHS
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL; 57-88-5/Cholesterol

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