LDL Cholesterol Not the Only Culprit in Heart Disease

Risk also increases with elevated non-high-density lipoprotein cholesterol and triglycerides

THURSDAY, Dec. 31 (HealthDay News) -- Though low-density lipoprotein cholesterol (LDL-C) is usually the primary target of lipid-lowering therapies, high levels of non-high-density lipoprotein cholesterol (HDL-C) and triglycerides, and a high total cholesterol/HDL-C ratio also carry an elevated risk for coronary heart disease (CHD), according to a study in the Dec. 29/Jan. 5 issue of the Journal of the American College of Cardiology.

Benoit J. Arsenault, Ph.D., of the Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, and colleagues analyzed baseline lifestyle data and serum lipid profiles of 21,448 subjects from the European Prospective Investigation Into Cancer and Nutrition study who did not have diabetes or CHD. The group was followed for an average of 11 years.

In follow-up, the researchers found that subjects with low LDL-C levels (less than 100 mg/dL) had increased risk for developing CHD when other lipids were elevated: for levels of HDL-C greater than 130 mg/dL, hazard ratio, 1.84; for triglyceride levels greater than 150 mg/dL, 1.63; and for a total cholesterol/HDL-C ratio greater than 5, 2.19.

"In this prospective study, independently of their plasma LDL-C levels, participants with high non-HDL-C levels, high triglyceride levels, or with an elevated total cholesterol/HDL-C ratio were at increased CHD risk. CHD risk assessment algorithms as well as lipid targets of lipid-lowering trials may also need to consider other easily available parameters such as non-HDL-C," the authors conclude.

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