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Low Triglycerides–High High-Density Lipoprotein Cholesterol and Risk of Ischemic Heart Disease
Jørgen Jeppesen, MD;
Hans Ole Hein, MD;
Poul Suadicani, DD;
Finn Gyntelberg, MD
Arch Intern Med. 2001;161:361-366.
Background A high triglyceride (TG)–low high-density lipoprotein cholesterol
(HDL-C) level (TG  1.60 mmol/L [142 mg/dL] and HDL-C  1.18 mmol/L
[46 mg/dL]) is associated with a high risk of ischemic heart disease (IHD),
whereas a low TG–high HDL-C level (TG 1.09 [97 mg/dL] and HDL-C 1.48
mmol/L [57 mg/dL]) is associated with a low risk. Conventional risk factors
tend to coexist with high TG–low HDL-C levels. We tested the hypothesis
that subjects with conventional risk factors would still have a low risk of
IHD if they had low TG–high HDL-C levels.
Methods Observational cohort study of 2906 men aged 53 to 74 years free of IHD
at baseline.
Results During 8 years, 229 subjects developed IHD. Stratified by conventional
risk factors—low-density lipoprotein cholesterol level (4.40 mmol/L
or >4.40 mmol/L [170 mg/dL or >170 mg/dL] [median value]), hypertensive
status (blood pressure >150/100 mm Hg or taking medication), level of physical
activity (>4 h/wk or 4 h/wk), and smoking status (nonsmokers vs smokers)—the
incidence in men with high TG–low HDL-C levels was 9.8% to 12.2% in
the low-risk and 12.2% to 16.4% in the high-risk strata; the corresponding
values in men with low TG–high HDL-C concentrations were 4.0% to 5.1%
and 3.7% to 5.3%, respectively. Based on an estimate of attributable risk,
35% of IHD might have been prevented if all subjects had had low TG–high
HDL-C levels.
Conclusion Men with conventional risk factors for IHD have a low risk of IHD if
they have low TG–high HDL-C levels.
From The Copenhagen Male Study, Epidemiological Research Unit, Copenhagen
University Hospital, Bispebjerg (Drs Jeppesen, Hein, Suadicani, and Gyntelberg),
and The Glostrup Population Studies, Department of Internal Medicine C, Glostrup
University Hospital, Glostrup (Dr Hein), Denmark.
Corresponding author and reprints: Jørgen Jeppesen, MD, The
Copenhagen Male Study, Epidemiological Research Unit, Copenhagen University
Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.
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