RISK FACTORS IN CORONARY HEART DISEASE. AN EVALUATION OF SEVERAL SERUM LIPIDS AS PREDICTORS OF CORONARY HEART DISEASE; THE FRAMINGHAM STUDY.

A T FRAMINGHAM, MASSACHUSETTS, the Na± \ . tional Heart Institute has been following 5,127 men and women aged 30 to 60 years in a study of factors related to the development of coronary heart disease (CHD) and hypertension. Data for a decade of follow-up studies of this population are available for analysis. From a study of those who have developed disease under observation in comparison to those who have remained free of the disease, factors of risk and susceptible individuals have been identified. The factors associated with excess risk that have been identified are: serum cholesterol level, blood pressure, cigarette smoking, vital capacity, relative weight, and certain electrocardiographic findings. Efforts are being made to assess the independent contribution of each of these factors to the development of coronary heart disease because of the therapeutic, preventive, and pathogenetic implications of this information. This report focuses on the serum lipids. Attempt will be made to assess the relative efficacy of the various lipids as predictors of coronary heart disease and to determine their independent contribution to risk of the development of the disease. The present report deals with three types of lipids: cholesterol, phospholipids, and various beta-lipoprotein fractions. The relationship of various indexes, based on these lipids, to development of disease will also be assessed. Evaluation of the serum triglycerides in relation to development of disease will not be included, since this measurement was introduced in the study too recently for prospective analysis.