EPIDEMIOLOGIC ASPECTS OF HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL

Most of the results from epidemiologic studies support the general ide a that high density lipoproteins (HDL) cholesterol is inversely relate d to coronary heart disease (CHD) incidence. Results from the literatu re and from a large cohort study in Belgium (the BIRNH study) are used to describe the distribution and the major determinants of HDL choles terol. HDL cholesterol is influenced by a variety of biologic, environ mental and behavioral characteristics. Results of a 10-year mortality follow-up of the BIRNH study are presented and compared to those obser ved in other large cohort studies. The inverse relationship between HD L cholesterol and CHD is confirmed, although the strength of the assoc iation varies between studies and is weakened after adjustment for oth er coronary risk factors. The results from the BIRNH study also sugges t that the relation between HDL cholesterol and CVD mortality is curvi linear. At present, only indirect evidence is available to support the idea that raising HDL cholesterol is useful in primary and secondary prevention of CHD. (C) 1998 Elsevier Science Ireland Ltd. All rights r eserved.