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European Heart Journal 1990 11(Supplement H):9-14; doi:10.1093/eurheartj/11.suppl_H.9
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Isolated low HDL-cholesterol as an important risk factor for coronary heart disease

M. Miller* and P. O. Kwiterovich, JR

Lipid Research-Atherosclerosis Unit Baltimore, Maryland, U.S.A.
* Division of Cardiology, The Johns Hopkins University School of Medicine Baltimore, Maryland, U.S.A.

Address, for correspondence: Peter O. KwitCrovkh, Jr, MD, Lipid Research-Atherosclerosis Unit, Departments of Pediatrics and Medicine, The Johns Hopkins University School of Medicine, 600 Wolfe Street, CMSC 604, Baltimorc, MD 21205, U.S.A.

Decreased levels of high density lipoprotein (HDL)-cholesterol are found in patients with hypertriglyceridaemia and in patients who have inherited disorders associated with premature coronary heart disease. Hereditary conditions associated with low levels of HDL-cholesterol and normal total cholesterol levels include familial hypoalphalipoproteinaemia, Tangier disease, fish eye disease, and lecithin: cholesterol acyltransferase deficiency. Secondary causes of low HDL-cholesterol levels include any condition that affects livermetabolism. A recent study of patients with coronary artery disease (CAD) who had normal levels of low density lipoprotein cholesterol and total cholesterol revealed that two-thirds of the men and four-fifths of the women had low HDL-cholesterol levels, suggesting that low HDL-cholesterol may be more prevalent than previously suspected. The high incidence of isolated hypoalphalipoproteinaemia in this group indicates that HDL-cholesterol measurements should be performed on all patients with CAD, regardless of their total cholesterol levels.

Key Words: Low density lipoproteins • high density lipoproteins • coronary artery disease • hypoalphalipoproteinaemia


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