DISTRIBUTION OF LIPIDS IN 8,500 MEN WITH CORONARY-ARTERY DISEASE

In the present study we measured fasting lipid profiles in over 8,500 community-living men with coronary artery disease (CAD) to determine t he distribution of lipid abnormalities in this population: 81% were wh ite and 16% black,; mean age 62.9 +/- 8 years; mean total cholesterol 214 +/- 41 mg/dl; low-density lipoprotein (LDL) cholesterol 140 +/- 37 mg/dl; high-density lipoprotein (HDL) cholesterol 39 +/- 11 mg/dl; an d triglycerides 190 +/- 142 mg/dl. After adjusting for age, the only s ignificant difference between blacks and whites was a higher HDL chole sterol in blacks (45 vs 38 mg/dl, p <0.003). With use of cut points es tablished by the National Cholesterol Education Program, 87% of subjec ts had high LDL cholesterol (greater than or equal to 100 mg/dl), 38% had HDL cholesterol (<35 mg/dl), and 33% had high triglycerides (>200 mg/dl). We estimated that 42% of men with CAD would be definite candid ates for cholesterol-lowering medication according to the National Cho lesterol Education Program guidelines and that 41% of those in whom ch olesterol-lowering medication would not be definitely indicated had lo w levels of HDL cholesterol. We conclude that (1) black men with CAD h ave substantially higher HDL cholesterol than white men, (2) almost 90 % of male patients with CAD are candidates for dietary intervention an d >40% may need medications to lower LDL cholesterol, and (3) 40% of p atients without a definite indication for cholesterol-lowering medicat ions have low levels of HDL cholesterol.