Plasma lipid levels and the diagnosis of coronary arteriosclerosis in England.
1966; BMJ; Volume: 28; Issue: 5 Linguagem: Inglês
10.1136/hrt.28.5.638
ISSN1468-201X
Autores Tópico(s)Liver Disease Diagnosis and Treatment
ResumoAlthough each of the different plasma lipids has, at some time, been proposed as an index of the time when symptoms of coronary heart disease will appear in apparently healthy people, none has yet gained indisputed approval.This has been due partly to the discordant results produced by diff- erent groups working in similar societies, but also, as Page et al. (1957) pointed out, because it was not known what concentration of plasma lipid could be regarded as abnormally high.In particular, they questioned whether it was appropriate to adopt, as a "normal" level, the average for a North American (or European) population.Later, it was deduced by Keys and Fidanza (1960) that their studies of the inhabitants of Minneapolis and Naples did "not support the idea that there is a 'normal' serum chol- esterol level for clinically healthy middle-aged men in general, or that there is some kind of a critical level that distinguishes all average coronary patients."The present note describes an analysis of lipoprotein measurements in men born and bred in this country, which confirms and extends this opinion.METHODS Definition of Disease.This discussion will be re- stricted to coronary arteriosclerosis, which will be assumed to be a major cause of heart disease arising through obstruction of the coronary lumen.The term "diseased" will be applied only to subjects in whom symptoms of this disease have become manifest, i.e. those who are suffering from angina pectoris, cardiac ischemia, myocardial infarction, or who have a characteristically changed electrocardiogram.All other subjects will be termed "healthy".Nomenclature.Where the discussion refers to the level of plasma cholesterol, it will be convenient to dis- tinguish between those measurements in which chol- Received October 6, 1965.638 esterol esters were hydrolysed, and those in which theywere not.The former, true estimate will be designated as: CHOLESTEROL, while the latter will be written, on July 25,
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