This paper is only available as a PDF. To read, Please Download here.
Abstract
The Expert Panel of the National Cholesterol Education Program has identified 10 risk
factors for the occurrence of an atherosclerotic event. Each of these factors does
not represent an independent risk. Male sex, family history of premature coronary
events, cigarette smoking (> 10/day), systemic hypertension, diabetes mellitus and
severe obesity (>30% overweight) should be viewed as cholesterol-dependent atherosclerotic
risk factors and not in themselves as atherogenic. There is no doubt that atherosclerotic
events are more common in people with these risk factors, but only in those populations
with an average serum total cholesterol level above 3.9 mmol/l. Those most prone to
having an atherosclerotic event are those who have already had such an event or who
have pre-existing coronary heart disease. However, by including these as risk factors,
no distinction is made between primary and secondary prevention. Atherosclerotic events
of any kind, though predictive of future events are not, by definition, true risk
factors and should not be viewed as such. The only absolute, unequivocal, independent
atherosclerotic risk factor is an elevated serum total or, more specifically, low
density lipoprotein (LDL)-cholesterol level. Whether a low level of high density lipoprotein
cholesterol is an independent risk factor is not clear, but it should probably be
regarded as an additive risk when the serum LDL-cholesterol is elevated.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to AtherosclerosisAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Modes of death, frequency of healed and acute myocardial infarcts, numbers of major epicardial coronary arteries severely narrowed by atherosclerotic plaque and heart weight in fatal atherosclerotic coronary artery disease: analysis of 889 patients studied at necropsy.J. Am. Coll. Cardiol. 1990; 15: 196
- Report of the National Cholesterol Education Program Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults.Arch. Intern. Med. 1988; 148: 36
- Is the relationship between serum cholesterol and risk of death from coronary heart disease continuous and graded? Findings in 365,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT).J. Am. Med. Assoc. 1986; 256: 2823
- Seven countries: a Multivariate Analysis of Death and Coronary Heart Disease.Harvard University Press, Cambridge, MA1980
- Incidence of coronary heart disease and lipoprotein cholesterol levels: the Framingham study.J. Am. Med. Assoc. 1986; 256: 2835
- Plasma lipid distributions in selected North American populations: the Lipid Research Clinics Program Prevalence Study.Circulation. 1979; 60: 427
- Frequency of systemic hypertension in various cardiovascular diseases.Am. J. Cardiol. 1987; 60: 1E
- Blood pressure, stroke and coronary heart disease. Part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context.Lancet. 1990; 335: 827
- High density lipoprotein as a protective factor against coronary heart disease.Am. J. Med. 1977; 62: 707
- The extramural and intramural coronary arteries in juvenile diabetes mellitus. Analysis of nine necropsy patients aged 19 to 38 years with onset of diabetes before age 15 years.Am. J. Med. 1978; 64: 221
Article info
Identification
Copyright
© 1992 Published by Elsevier Inc.
