Risk Factors in Coronary Heart Disease: An Evaluation of Several Serum Lipids as Predictors of Coronary Heart Disease: The Framingham Study

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Abstract
The efficacy of several serum lipids (cholesterol, phospholipids and [beta]-lipoproteins) and indices derived from them as predictors of coronary heart disease (CHD) has been examined in a longitudinal prospective study conducted at Framingham, Mass, in a population sample of 5127 men and women aged 30-59 years. Comparison of the lipids and lipid indices as predictors of CHD was made based on classification of subjects according to quartiles of the distribution of each lipid in the population. Of the lipids compared, cholesterol appeared to make the most significant independent contribution to risk of CHD. Most of the information derived from lipids relative to risk of developing CHD appeared to be contained in a kowledge of the serum cholesterol level. For the estimation of coronary pronenese no advantage appeared to exist in obtaining batteries of lipids, or indices derived from lipids. Such variability as exists in an individual''s serum cholesterol level did not prevent classification of subjects with reasonable precision into categories of proneness to CHD based on one reliable serum cholesterol level. As regards risk of CHD, no "safe" level of serum cholesterol was noted within the range of serum cholesterol levels observed in this population. Risk of developing CHD at any serum cholesterol concentration increased with the blood pressure level. Highly susceptible individuals with combinations of "elevated" cholesterol level and other easily identified risk factors, can be readily detected by the practicing physician using ordinary office procedures.