Plasma lipid levels and the diagnosis of coronary arteriosclerosis in England.

Abstract

Analyses of plasma lipoproteins by both the ultracentrifugal and the Conn techniques have shown that the average level of [alpha]-lipoprotein in healthy Englishmen is very similar to that found in other societies, whereas the level of [beta]-lipoprotein, though rather less than that of the average American, is substantially more than is found in communities with a lower standard of living. The concentration of both lipoprotein species increases with the age of the subject. Moreover, it has been shown that, when the total plasma cholesterol level increases, it is almost entirely the result of a rise in [beta]-cholesterol level, the concentration of a-cholesterol remaining almost unchanged. In subjects suffering from atherosclerotic coronary heart disease there is a significant depression of a-cholesterol levels below, and an increase of [beta]-cholesterol levels above those in healthy men. By combining the frequency distributions for healthy and diseased men, a relation between plasma cholesterol and the incidence of disease was deduced. This strongly favors the view that the rate of incidence in a society can be related to the mean plasma lipid level of its members. In particular, a level of -cholesterol above about 100 mg/100 ml, or of total cholesterol more than 150 mg/100 ml, may be considered as abnormal. It can be shown, however, to be impracticable to estimate the status of atherosclerotic coronary heart disease in an individual from plasma lipid measurements alone.