Triglycerides and HDL-cholesterol as risk factors for ischemic heart disease. Results from the Québec cardiovascular study

• Published in: Atherosclerosis 1996-01, Vol.119 (2), p.235-245
• Main Authors: Lamarche, Benoît, Després, Jean-Pierre, Moorjani, Sital, Cantin, Bernard, Dagenais, Gilles R., Lupien, Paul-J.
• Format: Article
• Language: English
• Subjects: Adult; Alcohol; Alcohol Drinking - epidemiology; Biological and medical sciences; Cardiology. Vascular system; Cholesterol; Cholesterol, HDL - blood; Cohort Studies; Comorbidity; Coronary heart disease; Disease Susceptibility - blood; Disease Susceptibility - epidemiology; Electrocardiography; HDL-C; Heart; human health and safety; human nutrition; Humans; Hypertriglyceridemia - complications; Hypertriglyceridemia - epidemiology; Infant; Lipids - blood; Male; Mass Screening; Medical sciences; medicine; Middle Aged; Myocardial Ischemia - blood; Myocardial Ischemia - epidemiology; Myocardial Ischemia - etiology; Obesity - epidemiology; Phenotype; Prevalence; Quebec - epidemiology; Risk Factors; Triglycerides; Triglycerides - blood
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/0021-9150(95)05653-X

The relative importance of reduced plasma high density lipoprotein-cholesterol (HDL-C) levels and elevated plasma triglyceride (TG) concentrations as risk factors for ischemic heart disease (IHD) was examined in a sample of 2177 men from the Québec City suburbs. The sample included 202 men with known IHD. The relationship between HDL-C and TG levels, although significant ( r = −0.49, P < 0.0001), was not linear, as most of the variation in HDL-C levels was observed within TG levels below 2.5 mmol/1. Reduced HDL-C ( 2.3 mmol/l). A 2-fold increase in prevalence odds ratio (OR) was observed in men with TG levels > 2.3 mmol/1 (95% confidence intervals (CI) [1.2;3.3]). No residual association between elevated TG levels and IHD was found, however, after adjustment for HDL-C concentrations (OR 1.2, 95% CI 0.7;2.1). On the other hand, HDL-C remained a significant predictor of IHD after adjustment for other risk factors (OR 0.3, 95%, CI 0.2;0.6). Men with reduced HDL-C levels were also characterized by a cluster of risk factors such as obesity, diabetes mellitus and hypertension, which may contribute to increase the risk of IHD. Finally, the independent interpretation of cholesterol, TG or LDL-C levels may lead to an inadequate prediction of risk, as a large number of IHD patients showed a cluster of risk factors which included low HDL-C concentrations.