Skip to main content
PMC home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1973 Jul;52(7):1533–1543. doi: 10.1172/JCI107331

Hyperlipidemia in Coronary Heart Disease I. LIPID LEVELS IN 500 SURVIVORS OF MYOCARDIAL INFARCTION

Joseph L Goldstein 1,2, William R Hazzard 1,2, Helmut G Schrott 1,2, Edwin L Bierman 1,2, Arno G Motulsky 1,2
PMCID: PMC302425  PMID: 4718952

Abstract

Plasma cholesterol and triglyceride levels were measured after an overnight fast in 500 consecutively studied 3-mo survivors of myocardial infarction. Virtually all patients under 60 yr of age (95% ascertainment) and a randomly chosen group of older survivors admitted to 13 Seattle hospitals during an 11 mo period were included. A comparison of their lipid values with those of 950 controls demonstrated that 31% had hyperlipidemia. These lipid abnormalities were most commonly found in males under 40 yr of age (60% frequency) and in females under 50 yr of age (60% frequency). Elevation in triglyceride levels with (7.8%) or without (15.6%) an associated elevation in cholesterol levels was three times more common in survivors than a high cholesterol level alone (7.6%). These results raise the possibility that hypertriglyceridemia may be as an important a risk factor for coronary atherosclerosis as hypercholesterolemia. The identification of hyperlipidemic survivors of myocardial infarction provided a unique source of probands for family studies designed to disclose the genetic origin of hyperlipidemia in coronary heart disease.

Full text

PDF
1534

Images in this article

1539Image
on p.1539
1539Image
on p.1539

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADLERSBERG D. Hypercholesteremia with predisposition to atherosclerosis, an inborn error of lipid metabolism. Am J Med. 1951 Nov;11(5):600–614. doi: 10.1016/0002-9343(51)90046-0. [DOI] [PubMed] [Google Scholar]
  2. ALBRINK M. J., MEIGS J. W., MAN E. B. Serum lipids, hypertension and coronary artery disease. Am J Med. 1961 Jul;31:4–23. doi: 10.1016/0002-9343(61)90220-0. [DOI] [PubMed] [Google Scholar]
  3. BIERMAN E. L., HAMLIN J. T., 3rd The hyperlipemic effect of a low-fat, high-carbohydrate diet in diabetic subjects. Diabetes. 1961 Nov-Dec;10:432–437. doi: 10.2337/diab.10.6.432. [DOI] [PubMed] [Google Scholar]
  4. Blankenhorn D. H., Chin H. P., Lau F. Y. Ischemic heart disease in young adults. Metabolic and angiographic diagnosis and the prevalence of type IV hyperlipoproteinemia. Ann Intern Med. 1968 Jul;69(1):21–33. doi: 10.7326/0003-4819-69-1-21. [DOI] [PubMed] [Google Scholar]
  5. Brown D. F., Kinch S. H., Doyle J. T. Serum triglycerides in health and in ischemic heart disease. N Engl J Med. 1965 Oct 28;273(18):947–952. doi: 10.1056/NEJM196510282731802. [DOI] [PubMed] [Google Scholar]
  6. CARLSON L. A. Determination of serum glycerides. Acta Soc Med Ups. 1959;64:208–213. [PubMed] [Google Scholar]
  7. CARLSON L. A. Serum lipids in men with myocardial infarction. Acta Med Scand. 1960 Aug 31;167:399–413. doi: 10.1111/j.0954-6820.1960.tb03562.x. [DOI] [PubMed] [Google Scholar]
  8. Carlson L. A., Böttiger L. E. Ischaemic heart-disease in relation to fasting values of plasma triglycerides and cholesterol. Stockholm prospective study. Lancet. 1972 Apr 22;1(7756):865–868. doi: 10.1016/s0140-6736(72)90738-6. [DOI] [PubMed] [Google Scholar]
  9. Carlson L. A., Lindstedt S. The Stockholm prospective study. 1. The initial values for plasma lipids. Acta Med Scand Suppl. 1968;493:1–135. [PubMed] [Google Scholar]
  10. Carlson L. A., Wahlberg F. Serum lipids, intravenous glucose tolerance and their interrelation studied in ischaemic cardiovascular disease. Acta Med Scand. 1966 Sep;180(3):307–315. doi: 10.1111/j.0954-6820.1966.tb02840.x. [DOI] [PubMed] [Google Scholar]
  11. Cramér K., Paulin S., Werkö L. Coronary angiographic findings in correlation with age, body weight, blood pressure, serum lipids, and smoking habits. Circulation. 1966 Jun;33(6):888–900. doi: 10.1161/01.cir.33.6.888. [DOI] [PubMed] [Google Scholar]
  12. Dyerberg J., Bang H. O., Nielsen J. A. Plasma lipids and lipoproteins in patients with myocardial infarction and in a control material. Acta Med Scand. 1970 May;187(5):353–363. doi: 10.1111/j.0954-6820.1970.tb02956.x. [DOI] [PubMed] [Google Scholar]
  13. Enger S. C., Ritland S. Serum lipoprotein pattern in myocardial infarction. Acta Med Scand. 1970 May;187(5):365–369. doi: 10.1111/j.0954-6820.1970.tb02957.x. [DOI] [PubMed] [Google Scholar]
  14. Epstein F. H., Ostrander L. D., Jr Detection of individual susceptibility toward coronary disease. Prog Cardiovasc Dis. 1971 Jan;13(4):324–342. doi: 10.1016/s0033-0620(71)80010-5. [DOI] [PubMed] [Google Scholar]
  15. Epstein F. H. Risk factors in coronary heart disease--environmental and hereditary influences. Isr J Med Sci. 1967 Jul-Aug;3(4):594–607. [PubMed] [Google Scholar]
  16. Falsetti H. L., Schnatz J. D., Greene D. G., Bunnell I. L. Serum lipids and glucose tolerance in angiographically proved coronary artery disease. Chest. 1970 Aug;58(2):111–115. doi: 10.1378/chest.58.2.111. [DOI] [PubMed] [Google Scholar]
  17. Goldstein J. L., Hazzard W. R., Schrott H. G., Bierman E. L., Motulsky A. G. Genetics of hyperlipidemia in coronary heart disease. Trans Assoc Am Physicians. 1972;85:120–138. [PubMed] [Google Scholar]
  18. Goldstein J. L., Schrott H. G., Hazzard W. R., Bierman E. L., Motulsky A. G. Hyperlipidemia in coronary heart disease. II. Genetic analysis of lipid levels in 176 families and delineation of a new inherited disorder, combined hyperlipidemia. J Clin Invest. 1973 Jul;52(7):1544–1568. doi: 10.1172/JCI107332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. HAMILTON M., PICKERING G. W., ROBERTS J. A. F., SOWRY G. S. The aetiology of essential hypertension. 4. The role of inheritance. Clin Sci. 1954 May;13(2):273–304. [PubMed] [Google Scholar]
  20. HAVEL R. J., CARLSON L. A. Serum lipoproteins, cholesterol and triglycerides in coronary heart disease. Metabolism. 1962 Feb;11:195–197. [PubMed] [Google Scholar]
  21. Hazzard W. R., Goldstein J. L., Schrott M. G., Motulsky A. G., Bierman E. L. Hyperlipidemia in coronary heart disease. 3. Evaluation of lipoprotein phenotypes of 156 genetically defined survivors of myocardial infarction. J Clin Invest. 1973 Jul;52(7):1569–1577. doi: 10.1172/JCI107333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Hazzard W. R., Spiger M. J., Bagdade J. D., Bierman E. L. Studies on the mechanism of increased plasma triglyceride levels induced by oral contraceptives. N Engl J Med. 1969 Feb 27;280(9):471–474. doi: 10.1056/NEJM196902272800904. [DOI] [PubMed] [Google Scholar]
  23. Heinle R. A., Levy R. I., Frederickson D. S., Gorlin R. Lipid and carbohydrate abnormalities in patients with angiographically documented coronary artery disease. Am J Cardiol. 1969 Aug;24(2):178–186. doi: 10.1016/0002-9149(69)90401-9. [DOI] [PubMed] [Google Scholar]
  24. JOHNSON B. C., EPSTEIN F. H., KJELSBERG M. O. DISTRIBUTIONS AND FAMILIAL STUDIES OF BLOOD PRESSURE AND SERUM CHOLESTEROL LEVELS IN A TOTAL COMMUNITY--TECUMSEH, MICHIGAN. J Chronic Dis. 1965 Feb;18:147–160. doi: 10.1016/0021-9681(65)90098-6. [DOI] [PubMed] [Google Scholar]
  25. KROMAN H., NODINE J., BENDER S., BREST A. LIPIDS IN NORMALS AND PATIENTS WITH CORONARY ARTERY DISEASE. Am J Med Sci. 1964 Nov;248:571–580. doi: 10.1097/00000441-196411000-00009. [DOI] [PubMed] [Google Scholar]
  26. Kannel W. B., Castelli W. P., Gordon T., McNamara P. M. Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham study. Ann Intern Med. 1971 Jan;74(1):1–12. doi: 10.7326/0003-4819-74-1-1. [DOI] [PubMed] [Google Scholar]
  27. Kuo P. T. Current metabolic-genetic interrelationship in human atherosclerosis, with therapeutic considerations. Ann Intern Med. 1968 Feb;68(2):449–466. doi: 10.7326/0003-4819-68-2-449. [DOI] [PubMed] [Google Scholar]
  28. Masarei J. R., Summers M., Curnow D. H., Cullen K. J., McCall M. G., Stenhouse N. S., Welborn T. A. Lipoprotein electrophoretic patterns, serum lipids, and coronary heart disease. Br Med J. 1971 Jan 9;1(5740):78–82. doi: 10.1136/bmj.1.5740.78. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Most A. S., Peterson D. R. Myocardial infarction surveillance in a metropolitan community. JAMA. 1969 Jun 30;208(13):2433–2438. [PubMed] [Google Scholar]
  30. Ostrander L. D., Jr, Neff B. J., Block W. D., Francis T., Jr, Epstein F. H. Hyperglycemia and hypertriglyceridemia among persons with coronary heart disease. Ann Intern Med. 1967 Jul;67(1):34–41. doi: 10.7326/0003-4819-67-1-34. [DOI] [PubMed] [Google Scholar]
  31. Patterson D., Slack J. Lipid abnormalities in male and female survivors of myocardial infarction and their first-degree relatives. Lancet. 1972 Feb 19;1(7747):393–399. doi: 10.1016/s0140-6736(72)90853-7. [DOI] [PubMed] [Google Scholar]
  32. Peterson D. R., Thompson D. J., Chinn N. Ischemic heart disease prognosis. A community-wide assessment (1966-1969). JAMA. 1972 Mar 13;219(11):1423–1427. [PubMed] [Google Scholar]
  33. Rifkind B. M., Lawson D., Gale M. Diagnostic value of serum lipids and frequency of lipoprotein patterns in myocardial infarction. J Atheroscler Res. 1968 Jan-Feb;8(1):167–176. doi: 10.1016/s0368-1319(68)80090-0. [DOI] [PubMed] [Google Scholar]
  34. Rose G. A., Blackburn H. Cardiovascular survey methods. Monogr Ser World Health Organ. 1968;56:1–188. [PubMed] [Google Scholar]
  35. STAMLER J., LINDBERG H. A., BERKSON D. M., SHAFFER A., MILLER W., POINDEXTER A. Prevalence and incidence of coronary heart disease in strata of the labor force of a Chicago industrial corporation. J Chronic Dis. 1960 Apr;11:405–420. doi: 10.1016/0021-9681(60)90046-1. [DOI] [PubMed] [Google Scholar]
  36. Shanoff H. M., Little J. A., Csima A. Studies of male survivors of myocardial infarction. XII. Relation of serum lipids and lipoproteins to survival over a 10-year period. Can Med Assoc J. 1970 Oct 24;103(9):927–931. [PMC free article] [PubMed] [Google Scholar]
  37. Slack J., Evans K. A. The increased risk of death from ischaemic heart disease in first degree relatives of 121 men and 96 women with ischaemic heart disease. J Med Genet. 1966 Dec;3(4):239–257. doi: 10.1136/jmg.3.4.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. THOMAS C. B., COHEN B. H. The familial occurrence of hypertension and coronary artery disease, with observations concerning obesity and diabetes. Ann Intern Med. 1955 Jan;42(1):90–127. doi: 10.7326/0003-4819-42-1-90. [DOI] [PubMed] [Google Scholar]
  39. Wilson W. S., Hulley S. B., Burrows M. I., Nichaman M. Z. Serial lipid and lipoprotein responses to the American Heart Association fat-controlled diet. Am J Med. 1971 Oct;51(4):491–503. doi: 10.1016/0002-9343(71)90255-5. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES