| Cholesterol measures to identify and treat individuals at risk for coronary heart disease. | |
| | |
MedLine Citation:
|
PMID: 12818310 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Low-density lipoprotein (LDL)-based guidelines are currently used to initiate and monitor cholesterol-lowering therapy. METHODS: Using stratified analyses, data from the Framingham Heart Study and the Coronary Primary Prevention Trial were evaluated to determine whether (1) cholesterol levels (total cholesterol [TC] or LDL [low-density lipoprotein]) better discriminated risk for coronary heart disease (CHD) than cholesterol ratios (LDL/HDL [high-density lipoprotein] or TC/HDL); and (2) whether changes in ratios better predicted risk reduction than changes in levels. RESULTS: Individuals with similar LDL/HDL ratios had similar risks for CHD regardless of whether they had high LDL levels or low LDL levels (23% vs 23% for the CPPT, 13.8% vs 14% for FHS men, and 8.6% vs 10.9% for FHS women). Among men with similar initial LDL/HDL ratios and similar changes in LDL/HDL ratios, risks for CHD did not differ (20.3% compared with 21.0%; p =0.96) between those with the largest and smallest reductions in LDL levels (21.3% compared with 6.5%). Among men with similar initial LDL levels and similar LDL reductions, a 20% reduction in risk for CHD was seen (19.5% compared with 24.5%; p =0.005) between those with the largest and smallest reductions in LDL/HDL ratios (23% compared with 4.6%). TC/HDL had predictive ability similar to LDL/HDL. CONCLUSIONS: Cholesterol levels do not provide incremental predictive value over cholesterol ratios in identifying people at risk for CHD. Changes in ratios are better predictors of successful CHD risk reduction than changes in levels. Future guidelines should consider incorporating ratios in initiating and monitoring successful lipid-lowering therapy. |
| | |
Authors:
|
Sundar Natarajan; Henry Glick; Michael Criqui; David Horowitz; Stuart R Lipsitz; Bruce Kinosian |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: American journal of preventive medicine Volume: 25 ISSN: 0749-3797 ISO Abbreviation: Am J Prev Med Publication Date: 2003 Jul |
Date Detail:
|
Created Date: 2003-06-23 Completed Date: 2003-09-16 Revised Date: 2007-11-14 |
Medline Journal Info:
|
Nlm Unique ID: 8704773 Medline TA: Am J Prev Med Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 50-7 Citation Subset: IM |
Affiliation:
|
Department of Medicine, VA New York Harbor Healthcare System (Natarajan), New York, New York 10010, USA. sundar.natarajan@med.nyu.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Cholesterol, HDL
/
blood* Cholesterol, LDL / blood* Coronary Disease / epidemiology*, etiology, therapy Female Humans Male Placebos Risk Assessment / methods* Risk Factors United States |
| Grant Support | |
ID/Acronym/Agency:
|
HL61769/HL/NHLBI NIH HHS; R-29-AG09837/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Placebos |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Predictors of age-appropriate receipt of DTaP dose 4.
Next Document: Child death review. The state of the nation.