Cited by 3,162Lipoproteins and Cardiovascular HealthCardiovascular Health and Risk FactorsDiabetes, Cardiovascular Risks, and Lipoproteins

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High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies.

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Gordon, D J, Probstfield, J L, Garrison, R J, Neaton, J D, Castelli, W P, Knoke, J D, Jacobs, D R, Bangdiwala, S, Tyroler, H A·1989·Circulation

DOI 10.1161/01.cir.79.1.8

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Abstract

The British Regional Heart Study (BRHS) reported in 1986 that much of the inverse relation of high-density lipoprotein cholesterol (HDLC) and incidence of coronary heart disease was eliminated by covariance adjustment. Using the proportional hazards model and adjusting for age, blood pressure, smoking, body mass index, and low-density lipoprotein cholesterol, we analyzed this relation separately in the Framingham Heart Study (FHS), Lipid Research Clinics Prevalence Mortality Follow-up Study (LRCF) and Coronary Primary Prevention Trial (CPPT), and Multiple Risk Factor Intervention Trial (MRFIT). In CPPT and MRFIT (both randomized trials in middle-age high-risk men), only the control groups were analyzed. A 1-mg/dl (0.026 mM) increment in HDLC was associated with a significant coronary heart disease risk decrement of 2% in men (FHS, CPPT, and MRFIT) and 3% in women (FHS). In LRCF, where only fatal outcomes were documented, a 1-mg/dl increment in HDLC was associated with significant 3.7% (men) and 4.7% (women) decrements in cardiovascular disease mortality rates. The 95% confidence intervals for these decrements in coronary heart and cardiovascular disease risk in the four studies overlapped considerably, and all contained the range 1.9-2.9%. HDLC levels were essentially unrelated to non-cardiovascular disease mortality. When differences in analytic methodology were eliminated, a consistent inverse relation of HDLC levels and coronary heart disease event rates was apparent in BRHS as well as in the four American studies.

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Authors: Gordon, D. J., Probstfield, J. L., Garrison, R. J., Neaton, J. D., Castelli, W. P., Knoke, J. D., Jacobs, D. R., Bangdiwala, S., & Tyroler, H. A.
Affiliations: National Institutes of Health (US)
ORCID: Probstfield, J L
Neaton, J D
Knoke, J D
Jacobs, D R
Bangdiwala, S
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1989-01
Volume: 79
Issue: 1
Pages: 8-15
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.79.1.8
OpenAlex: W2077760013
Cited by: 3,162
References: 27
Citations by year: 2026: 35 · 2025: 41 · 2024: 62 · 2023: 69 · 2022: 90 · 2021: 90 · 2020: 90 · 2019: 84 · 2018: 96 · 2017: 87 · 2016: 81 · 2015: 125 · 2014: 137 · 2013: 125 · 2012: 129
FWCI: 61.95
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01hv012156-034)
National Heart, Lung, and Blood Institute (N01-HV32961, N01-HV 12156, N01-HV 12159)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: HDL cholesterol, coronary artery disease, cardiovascular mortality, inverse association, Framingham Heart Study, Multiple Risk Factor Intervention Trial, British Regional Heart Study, cardiovascular risk, sex differences
MeSH terms: Adult, Aged, Cardiovascular Diseases, Clinical Trials as Topic, Female, Humans, Cholesterol, HDL, Male, Middle Aged, Prospective Studies, Regression Analysis, Risk Factors, Sex Factors, Statistics as Topic, Cohort Studies

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High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies.

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