Serum Lipoproteins and Coronary Heart Disease in a Population Study of Hawaii Japanese Men

To ascertain the frequency of defined hyperlipoproteinemia and to investigate the relation between lipoprotein fractions and coronary heart disease, we measured serum lipoprotein cholesterol levels in a population-based sample of Hawaii Japanese men 50 to 72 years old. Type I.I. hyperlipoproteinemia was present in 3 per cent of 1859 men, and Type I.V. in 26 per cent. Relative risks for coronary heart disease, based on 264 prevalence cases, were found to be 1.8, 1.8 and 0.46, between the upper and lower quartiles of total, beta, and alpha cholesterol, respectively. We found no significant relation between triglyceride and coronary heart disease. The inverse relation of alpha cholesterol to prevalence of coronary heart disease was independent of beta cholesterol, obesity, and other factors. The data suggest the need for further evaluation of the protective effect of the alpha lipoprotein fraction on the development of coronary heart disease. (N Engl J Med 294: 293-298,1976). Despite extensive literature relating serum lipids to coronary heart disease, there have been only a limited number of population based studies that have related specific serum lipoprotein fractions to the disease. Most of these have been in white populations. We have had an opportunity to carry out lipoprotein determinations in a Westernizing population of Japanese origin. The distribution of serum lipids in this population is somewhat different from that in typical white subjects studied.¹The relation of these lipid levels to the prevalence of coronary heart disease in this free-living population is analyzed in this report. Methods The Honolulu Heart.