High density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women: The follow-up study of the lipid research clinics prevalence study

David R. Jacobs, Irma L. Mebane, Shrikant I. Bangdiwala, Michael H. Criqui, Herman A. Tyroler

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With data from the Lipid Research Clinics Prevalence Study used as a baseline, an average of 8.4 years of mortality follow-up has been completed for 8,825 male and female participants who were at least 30 years of age at the time of the study. The participants were examined at 10 North American sites during 1972-1976. Univariate findings for high density lipoprotein (HDL) cholesterol in the 7,589 persons initially free of coronary heart disease indicate an inverse relation with cardiovascular disease mortality for men and women. Controlling for age, low density lipoprotein (LDL) cholesterol, triglycerides, body mass index, systolic blood pressure, and smoking, multivarlate analysis results indicate inverse relations between HDL cholesterol and cardiovascular disease mortality. In men, the cardiovascular disease mortality rate ratio for HDL cholesterol increments of 10 mg/dl was similar to the cardiovascular disease mortality rate ratio for LDL cholesterol increments of 30 mg/dl. In women, HDL cholesterol is more closely related to cardiovascular disease than is LDL cholesterol. HDL cholesterol is inversely related to both coronary heart disease and other cardiovascular disease mortality in both sexes, though the relation of HDL cholesterol with coronary heart disease mortality in women approached statistical significance only for the combined end point of suspect and definite cases. No relation was observed in either sex group between HDL cholesterol and noncardiovascular disease mortality. This study, only the second large prospective study evaluating the role of HDL cholesterol in women, confirms both the importance and the independence in both men and women of HDL cholesterol in the epidemiology of coronary heart disease and other cardiovascular disease mortality.

Original languageEnglish (US)
Pages (from-to)32-47
Number of pages16
JournalAmerican journal of epidemiology
Issue number1
StatePublished - Jan 1990

Bibliographical note

Funding Information:
NC. * Division of Epidemiology, Department of Com-munity and Family Medicine, University of California, San Diego, La Jolla, CA. 'Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC. Reprint requests to Dr. Basil M. Rifkind, Chief, Lipid Metabolism-Atherogenesis Branch, NHLBI, National Institutes of Health, Federal Building, Room 401, Bethesda, MD 20892. This work was supported by the following National Heart, Lung, and Blood Institute contracts: N01-HV12159,-N01-HV12156, N01-HV32961, N01-HV12160, N01-HV22914, N01-HV22913, N01-HV12158, N01-HV12161, N01-HV22915, N01-HV12903, N01-HV12243, N01-HV22932, N01-HV22917, N01-HV12157, and Y01-HV30010. Members of the Lipid Research Clinics Foiiow-up Study Executive: Dr. H. A. Tyroler (Chairman), Dr. Shrikant L Bangdiwala, Dr. Elizabeth Barrett-Connor, Dr. C. E. Davis, Dr. Manning Feinleib, Dr. William R. Hazzard, Dr. David R. Jacobs, Jr., Leslie Kirkland-EUia, Dr. Irma Mebane, Dr. Richard Mowery, Dr. Ronald Pnneas, Dr. Basil M. Rifkind, Dr. Carl Rubenstein, and Dr. William J. Schull. Follow-up Study Directors: Dr. Elizabeth Barrett-Connor, Dr. Reagan Bradford, Dr. Bobbe Christensen, Dr. Linda Cowan, Dr. Michael Cnqin, Dr. William Haskell, Dr. Joanne Hoover, Dr. David Jacobs, Jr., Dr. J. Alick Little, Dr. John A. Morrison, Dr. George Owen, Pearl Van Natta, Dr. Patricia Wahl, and Dr. Robert B. Wallace. Mortality Classification Panel: Dr. Arthur S. Leon, Dr. Ronald Pnneas, Dr. Carl Rubenstein (Chairman), Dr. Joseph Ruwitch, and Dr. John Wilson. Members of the Ltpid Research Clinics Directors ' Committee: Dr. Francois Abboud, Dr. W. Stewart Agras, Dr. Edwin Bierman, Dr. Reagan Bradford, Dr. Virgil Brown, Dr. Marilyn Buzzard, Dr. William Connor, Dr. Gerald Cooper, Dr. John Fartruhar, Dr. Ivan Frantz, Dr. Elena Gerasimova, Dr. Antonio Gotto, Dr. James Gnzzle, Dr. William R. Hazzard, Dr. Donald Hunninghake, Dr. Frank Ibbott, Dr. William Insull, Dr. Anatoli Klimov, Dr. Robert Knopp, Dr. Peter Kwiterovich, Dr. John C. LaRosa, Dr. J. Alick Little, Dr. Fred Mattson, Dr. Maurice Mishkel, Dr. Basil M. Rifkind, Dr. Gustav Schonfeld, Dr. Helmut Schrott, Dr. Yechezkiel Stein, Dr. Daniel Steinberg, Dr. George Steiner, and Dr. O. Dale Williams.


  • Coronary disease
  • Lipoproteins
  • Lipoproteins, HDL cholesterol
  • Mortality

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