B. Lamarche et al., TRIGLYCERIDES AND HDL-CHOLESTEROL AS RISK-FACTORS FOR ISCHEMIC-HEART-DISEASE - RESULTS FROM THE QUEBEC CARDIOVASCULAR STUDY, Atherosclerosis, 119(2), 1996, pp. 235-245
The relative importance of reduced plasma high density lipoprotein-cho
lesterol (HDL-C) levels and elevated plasma triglyceride (TG) concentr
ations as risk factors for ischemic heart disease (IHD) was examined i
n a sample of 2177 men from the Quebec City suburbs. The sample includ
ed 202 men with known IHD. The relationship between HDL-C and TG level
s, although significant (r = -0.49, P < 0.0001), was not linear, as mo
st of the variation in HDL-C levels was observed within TG levels belo
w 2.5 mmol/l. Reduced HDL-C (< 0.9 mmol/l) was a prevalent condition i
n men with IHD (50%) compared to. those without IHD (30%). On the othe
r hand 26% and 20% of men with and without IHD, respectively, had elev
ated TG levels (TG > 2.3 mmol/l). A 2-fold increase in prevalence odds
ratio (OR) was observed in men with TG levels > 2.3 mmol/l (95% confi
dence intervals (CI) [1.2;3.3]). No residual association between eleva
ted TG levels and IHD was found, however, after adjustment for HDL-C c
oncentrations (OR 1.2, 95% CI 0.7;2.1). On the other hand, HDL-C remai
ned a significant predictor of IHD after adjustment fbr other risk fac
tors (OR 0.3, 95%, CI 0.2;0.6). Men with reduced HDL-C levels were als
o characterized by a cluster of risk factors such as obesity, diabetes
mellitus and hypertension, which may contribute to increase the risk
of IHD. Finally, the independent interpretation of cholesterol, TG or
LDL-C levels may lead to an inadequate prediction of risk, as a large
number of IHD patients showed a duster of risk factors which included
low HDL-C concentrations.