GENETIC STUDIES ON CORONARY ATHEROSCLEROSIS DEVELOPING AFTER THE AGE OF SIXTY YEARS

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Abstract
E VIDENCE has accumulated that an error of lipid metabolism is closely related to the process of atherogenesis in man and experimental animals.1 Many attempts have been made to characterize this disturbance of lipid metabolism. Elevation of the serum cholesterol level,2 alteration of the cholesterol-phospholipid ratio,1f-h higher concentrations of giant lipoprotein molecules,1i,j and abnormal shifts from alpha to beta lipoprotein1m have been studied. The precise role of each of these factors is still under investigation; each represents a different facet of the faulty lipid metabolism. Our previous studies on patients with coronary artery disease whose symptoms began before the age of 50, as well as on their siblings,3 and on families with xanthomatosis4 led to the conclusion that the common factor for patients with coronary atherosclerosis may be a genetically transmitted fault of lipid metabolism manifesting itself as hypercholesteremia.4 Familial xanthomatosis is the severest form of this inherited disturbance. Many