HDL CHOLESTEROL - TRENDS IN 2 SOUTHEASTERN NEW-ENGLAND COMMUNITIES, 1981-1993

PURPOSE: Although public health interventions have not specifically ca reered high density lipoprotein (HDL) cholesterol, observed changes in the prevalence of other cardiovascular risk factors would be expected to have differential effects on HDL. This study examined secular tren ds in HDL in relation to changes in other cardiovascular risk factors for the years 1981 through 1993 in the Pawtucket Heart Health Program (PHHP) study communities. METHODS: Nonfasting HDL levels a ere assesse d in 12,223 respondents to six biennial population random sample surve ys. RESULTS: Between 1981 and 1993, mean HDL cholesterol declined by 0 .08 mmol/L in both men and women after adjustment for age, city, educa tion, hormone use, medications, recent alcohol use, smoking, regular e xercise, body mass index (BMI), and total cholesterol, (p for trend < 0.001). There was no apparent laboratory explanation for the trend whi ch occurred concurrent with decreased smoking prevalence, increasing B MI and decreased prevalence of recent alcohol use. Decreasing HDL chol esterol was observed consistently across subgroups defined by smoking, alcohol use and BMI. CONCLUSIONS: Although several favorable cardiova scular risk factor trends have been observed in recent decades, declin ing HDL cholesterol is also of interest, particularly in conjunction w ith population increases in BMI. (C) 1998 Elsevier Science Inc.