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Cited by 74Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Health and Risk Factors

Serum cholesterol and relative body weight of coronary patients in different populations

KEYS, ANCEL, FIDANZA, FLAMINIO·1960·Circulation
DOI 10.1161/01.cir.22.6.1091
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Abstract

Men under 66 years of age suffering from unequivocal coronary heart disease in the Twin Cities of Minnesota and in Naples, Italy, were compared with clinically healthy men matched in place of residence, age, type of occupation, and socioeconomic status. The Twin Cities patients ( N = 72) did not differ in relative body weight from their controls ( N = 338) and the average relative weight of both groups was less than either of the 2 Naples coronary groups and the upper class Naples control subjects. The average relative body weight of the upper class Naples coronary patients ( N = 54) was insignificantly greater than that of their controls ( N = 89). The Naples working class coronary patients ( N = 54) had a significant tendency to be more often overweight than their controls ( N = 144). The serum total cholesterol concentration was significantly higher in each of the 3 groups of coronary patients than in their corresponding controls and the 3 groups, control and coronary, formed a sharp progression from high to low cholesterol values in the order: Twin Cities, Naples upper class, Naples working class. In the Naples working class, separation into manual and sedentary workers disclosed no differences in either relative body weight or serum cholesterol. The differences in serum cholesterol were accounted for by cholesterol in beta-lipoprotein. None of the 3 control groups differed in alpha-lipoprotein cholesterol concentration but in each of the 3 populations the coronary patients tended to have lower alpha values than their controls. The cholesterol data are compatible with the hypothesis that the 3 populations have different frequency distributions of cholesterol values, the coronary patients in each population tending to be drawn from the upper end of the corresponding population distribution, with no general critical level distinguishing all coronary patients as a total group. In the past several years coronary patients in the Twin Cities tend to be so frequently on diets or drugs to control cholesterol that it is increasingly difficult to find patients who may properly characterize the natural history of the disease. The patients reported here were free from this complication.

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  • The Framingham study included women, unlike contemporaneous epidemiological studies that had few or no women.

    “The study's inclusion of women contrasted with contemporaneous epidemiological studies, which had very small numbers of women or excluded them altogether.23,24”

    From The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective (2014) · cites this paper as [23]

  • In 1977, Framingham investigators reported an inverse relationship between HDL concentrations and coronary heart disease incidence.

    “In 1977, Gordon and other Framingham investigators reported an inverse relationship between HDL concentrations and coronary heart disease incidence, in contrast to the positive association between LDL concentrations and coronary heart disease incidence.74”

    From The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective (2014) · cites this paper as [74]

  • In 1977, Framingham investigators reported a positive association between LDL concentrations and coronary heart disease incidence.

    “In 1977, Gordon and other Framingham investigators reported an inverse relationship between HDL concentrations and coronary heart disease incidence, in contrast to the positive association between LDL concentrations and coronary heart disease incidence.74”

    From The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective (2014) · cites this paper as [74]

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Research works printed but not linked: 4

  1. GERTLER, M. M., WHITE, P. D., AND Others: Coronary Heart Disease in Young Adults. Cambridge, Mass., Harvard University Press, 1954, 218 pp.
  2. ASSOCIATION OF LIFE INSURANCE MEDICAL DIREC- TORS AND ACTUARIAL SOCIETY OF AMERICA. Medico-Mortality Investigations. Vol. 1, New York, 1912.
  3. SOCIETY OF ACTUARIES: Build and blood pressure study. Vol. 1. Chicago, Society Actuaries, 1959, 208 pp.
  4. -: Weight changes and health of men. In Weight Control. Edited by E. S. Eppright, P. Swanson, and C. A. Iverson. Ames, Iowa, Iowa State College Press, 1955, Chap. 8.

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Authors
KEYS, A., & FIDANZA, F.
Affiliations
University of Minnesota (US)
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1960-12
Volume
22
Issue
6
Pages
1091-1106
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.22.6.1091
OpenAlex
W2059201323
Cited by
74
References
49
Citations by year
2026: 3 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 2 · 2019: 1 · 2016: 1 · 2013: 1
FWCI
13.72
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
American Heart Association
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords
coronary artery disease, serum cholesterol, relative body weight, overweight, beta-lipoprotein cholesterol, socioeconomic class, population differences, Naples
MeSH terms
Body Weight, Body Weights and Measures, Cholesterol, Coronary Disease, Humans

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