Non-high-density lipoprotein cholesterol level as a predictor of cardiovascular disease mortality

Background: Non-high-density lipoprotein cholesterol (non-HDL-C) contains a ll known and potential atherogenic lipid particles. Therefore, non-HDL-C le vel may be as good a potential predictor of risk for cardiovascular disease (CVD) as low-density lipoprotein cholesterol (LDL-C). Objectives: To determine whether non-HDL-C level could be useful in predict ing CVD mortality and to compare the predictive value of non-HDL-C and LDL- C levels. Methods: Data are from the Lipid Research Clinics Program Follow-up Study, a mortality study with baseline data gathered from 1972 through 1976, and m ortality ascertained through 1995. A total of 2406 men and 2056 women aged 40 to 64 years at entry were observed for an average of 19 years, with CVD death as the main outcome measure. Results: A total of 234 CVD deaths in men and 113 CVD deaths in women occur red during follow-up. Levels of HDL-C and non-HDL-C at baseline were signif icant and strong predictors of CVD death in both sexes, In contrast, LDL-C level was a somewhat weaker predictor of CVD death in both. Differences of 0.78 mmol/L (30 mg/dL) in non-HDL-C and LDL-C levels corresponded to increa ses in CVD risk of 19% and 15%, respectively, in men. In women, differences of 0.78 mmol/L (30 mg/dL) in non-HDL-C and LDL-C levels corresponded to in creases in CVD risk of 11% and 8%, respectively. Conclusions: Non-HDL-C level is a somewhat better predictor of CVD mortalit y than LDL-C level. Screening for non-HDL-C level may be useful for CVD ris k assessment.