High density lipoprotein as a protective factor against coronary heart disease
Abstract
Lipid and lipoprotein values, including fasting triglycerides and high density lipoproteins (HDL), low density lipoproteins (LDL) and total cholesterol levels, were obtained on 2,815 men and women aged 49 to 82 years chiefly between 1969 and 1971 at Framingham. In the approximately four years following the characterization of lipids, coronary heart disease developed in 79 of the 1,025 men and 63 of the 1,445 women free of coronary heart diseases. At these older ages the major potent lipid risk factor was HDL cholesterol, which had an inverse association with the incidence of coronary heart disease (p less than 0.001) in either men or women. This lipid was associated with each major manifestation of coronary heart disease. These associations were equally significant even when other lipids and other standard risk factors for coronary heart disease were taken into consideration. A weaker association with the incidence of coronary heart disease (p less than 0.05) was observed for LDL cholesterol. Triglycerides were associated with the incidence of coronary heart disease only in women and then only when the level of other lipids was not taken into account. At these ages total cholesterol was not associated with the risk of coronary heart disease.
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In 1977, a collaborative study reported that individuals with coronary disease had lower HDL concentrations than healthy participants across multiple ethnicities.
“That same year, in collaboration with other epidemiological studies in the United States, investigators reported that individuals with coronary disease had lower HDL concentrations than healthy participants across multiple ethnicities.75”
From The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective (2014) · cites this paper as [75]
The classical view on the relationship between serum lipid levels and risk for cardiovascular events states that serum high LDL and low HDL cholesterol level is a risk combination for cardiovascular events.
“The classical view on the relationship between serum lipid levels and risk for cardiovascular events, formulated based on the findings of the Framingham study41 and since confirmed by many epidemiological studies, states that serum high LDL and low HDL cholesterol level is a risk combination for cardiovascular events42.”
From Prolonged sleep restriction induces changes in pathways involved in cholesterol metabolism and inflammatory responses (2016) · cites this paper as [41]
The Framingham Heart Study was the first large epidemiological study in the U.S. to demonstrate an inverse association between low HDL-C and coronary heart disease.
“The Framingham Heart Study was the first large epidemiological study in the U.S to demonstrate an inverse association between low HDL-C and coronary heart disease32”
From Is Isolated Low High-Density Lipoprotein Cholesterol a Cardiovascular Disease Risk Factor?: New Insights From the Framingham Offspring Study (2016) · cites this paper as [32]
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- Authors
- Gordon, T., Castelli, W. P., Hjortland, M. C., Kannel, W. B., & Dawber, T. R.
- Corresponding author
- Gordon, Tavia
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 1977-05
- Volume
- 62
- Issue
- 5
- Pages
- 707-714
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2094768566
- Cited by
- 5,059
- References
- 36
- Citations by year
- 2026: 34 · 2025: 65 · 2024: 73 · 2023: 59 · 2022: 64 · 2021: 74 · 2020: 89 · 2019: 94 · 2018: 99 · 2017: 101 · 2016: 122 · 2015: 163 · 2014: 135 · 2013: 140 · 2012: 140
- FWCI
- 248.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Paraoxonase enzyme and polymorphisms
- Keywords
- HDL cholesterol, coronary artery disease, cardiovascular risk factors, LDL cholesterol, triglycerides, total cholesterol, Framingham Heart Study, older adults, sex differences, serum lipids
- MeSH terms
- Age Factors, Aged, Coronary Disease, Female, Humans, Lipids, Lipoproteins, HDL, Lipoproteins, LDL, Male, Middle Aged, Risk, Sex Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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