SERUM-CHOLESTEROL AND HIGH-DENSITY LIPOPROTEIN-CHOLESTEROL IN CORONARY PATIENTS AND HEALTHY-PERSONS

Serum cholesterol (CH) and high density lipoprotein-cholesterol (HDL-CH) were determined in 154 male and in 68 female post-myocardial infarction (MI) patients and in 2706 healthy males and 1888 healthy females. CH values showed no significant differences between healthy subjects and MI patients (except in males 35-44 years old). HDL-CH values were significantly lower in MI patients than in healthy subjects. In addition, in subgroups with equal CH values, MI patients had significantly lower HDL-CH than healthy people. Healthy females had higher HDL-CH than healthy males with same CH levels, but there was no difference in HDL-CH between male and female coronary patients with equal CH values. The term HDL-CH%, indicating the percentage of total CH in the HDL, seems preferable to HDL-CH mg/100 ml, because it is independent of the level of CH. In the population surveyed, HDL-CH showed itself as a more reliable indicator for ischemic heart disease than CH. The hypothesis is advanced that the first step in the development of an atherogenic lipoprotein pattern is a re-distribution of CH between HDL on the one hand, and LDL plus VLDL on the other hand, the second step only being an increase of CH, mainly in the low density lipoprotein fractions. © 1979.