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High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies.
Open accessAbstract
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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“In fact, a 1 mg/dL (0.026 mmol/L) increment in HDL-C levels was associated with a significant decrease in the risk of coronary heart disease of 2% in men and 3% in women.6”
From MicroRNA‐33 Deficiency Reduces the Progression of Atherosclerotic Plaque in ApoE −/− Mice (2012) · cites this paper as [6]
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“Part of the protection that women have from CHD may be related to their high HDL-C levels.49,50”
From Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta‐Analysis of Prospective Cohorts (2012) · cites this paper as [50]
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Metadata
- 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)
- Venue
- Circulation
- Published
- 1989-01
- Volume
- 79
- Issue
- 1
- Pages
- 8-15
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- 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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