Wilbert S. Aronow, MD, CMD, Clinical Professor of Medicine, Department of Medicine, Divisions of Cardiology and Geriatrics, New York Medical College, Valhalla, NY.
Serum High-Density Lipoprotein Cholesterol
A low serum, high-density lipoprotein (HDL) cholesterol is a risk factor for the development of new coronary events in older men and women.1-6 In the Framingham Heart Study,1 in the Established Population for Epidemiologic Studies of the Elderly Study,4 and in 2,152 older men and women,3 a low serum HDL cholesterol was a more powerful predictor of new coronary events than was serum total cholesterol. In 1,793 older men and women, mean age 81 years, a decrease of 10 mg/dL (0.26 mmol/L) of serum HDL cholesterol significantly increased by 2.56 times, the probability of having coronary artery disease after controlling for other prognostic variables.2 At 48-month follow-up of 1,488 older women, mean age 82 years, and at 40-month follow-up of 664 older men, mean age 80 years, a decrease of 10 mg/dL (0.26 mmol/L) of serum HDL cholesterol significantly increased the relative risk of developing new coronary events by 1.95 times in women and by 1.7 times in men, after controlling for other prognostic variables.
