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Distribution of lipids in 8,500 men with coronary artery disease

  • Hanna Bloomfield Rubins
    Correspondence
    Address for reprints: Hanna Bloomfield Rubins, MD, MPH, Section of General Internal Medicine (1110), VA Medical Center, Minneapolis, Minnesota 55417.
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Sander J. Robins
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Dorothea Collins
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Ali Iranmanesh
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Timothy J. Wilt
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Douglas Mann
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Michael Mayo-Smith
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Fred H. Faas
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Marshall B. Elam
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Gale H. Rutan
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • James W. Anderson
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Moti L. Kashyap
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
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  • Author Footnotes
    * See Appendix for other author affiliations.
    ,
    Author Footnotes
    1 The VA HDL Intervention Trial is funded by the Department of Veterans Affairs, VA Cooperative Studies Program, and by a grant from the Parke-Davis Group, Division of the Warner Lambert Company, Morris Plains, New Jersey.
    Gordon Schectman
    Footnotes
    * See Appendix for other author affiliations.
    1 The VA HDL Intervention Trial is funded by the Department of Veterans Affairs, VA Cooperative Studies Program, and by a grant from the Parke-Davis Group, Division of the Warner Lambert Company, Morris Plains, New Jersey.
    Affiliations
    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.

    From the Section of General Internal Medicine and Department of Medicine, Minneapolis Veterans Affairs Medical Center (VAMC) and the University of Minnesota School of Medicine, Minneapolis, Minnesota U.S.A.

    From the Section of Lipid Metabolism and Department of Medicine, Boston VAMC and Boston University School of Medicine, Boston, Massachusetts U.S.A.

    From the Veterans Affairs (VA) Cooperative Studies Coordinating Center, West Haven VAMC, West Haven, Connecticut U.S.A.
    Search for articles by this author
  • Author Footnotes
    * See Appendix for other author affiliations.
    1 The VA HDL Intervention Trial is funded by the Department of Veterans Affairs, VA Cooperative Studies Program, and by a grant from the Parke-Davis Group, Division of the Warner Lambert Company, Morris Plains, New Jersey.
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      Abstract

      In the present study we measured fasting lipid profiles in over 8,500 community-living men with coronary artery disease (CAD) to determine the distribution of lipid abnormalities in this population: 81% were white and 16% black; mean age 62.9 ± 8 years; mean total cholesterol 214 ± 41 mg/dl; low-density lipoprotein (LDL) cholesterol 140 ± 37 mg/dl; high-density lipoprotein (HDL) cholesterol 39 ± 11 mg/dl; and triglycerides 190 ± 142 mg/dl. After adjusting for age, the only significant difference between blacks and whites was a higher HDL cholesterol in blacks (45 vs 38 mg/dl, p < 0.003). With use of cut points established by the National Cholesterol Education Program, 87% or subjects had high LDL cholesterol (≥100 mg/dl), 38% had low HDL cholesterol (<35 mg/dl), and 33% had high triglycerides (>200 mg/dl). We estimated that 42% of men with CAD would be definite candidates for cholesterol-lowering medication according to the National Cholesterol Education Program guidelines and that 41% of those in whom cholesterol-lowering medication would not be definitely indicated had low levels of HDL cholesterol. We conclude that (1) black men with CAD have substantially higher HDL cholesterol than white men, (2) almost 90% of male patients with CAD are candidates for dietary intervention and >40% may need medications to lower LDL cholesterol, and (3) 40% of patients without a definite indication for cholesterol-lowering medications have low levels of HDL cholesterol.
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