Cholesterol in the Prediction of Atherosclerotic Disease

Abstract

Prospective data at Framingham [Massachusetts, USA] and elsewhere have shown conclusively that risk of coronary heart disease in persons younger than age 50 is related to the serum total cholesterol level. Within normal limits risk mounted over a 5-fold range. The impact was augmented by other risk factors. The contribution of the serum total cholesterol to risk was also determined by its partition in the various lipoprotein fractions. A relatively large amount of cholesterol in the low-density lipoprotein fraction is atherogenic, but the high-density fraction appears protective. The independent contribution of very-low-density lipoprotein and its triglyceride or cholesterol content was not established. The previous position that virtually all of the lipid information pertaining to coronary heart disease resided in the serum total cholesterol must be modified.