Addendum

Abstract

Although the concentration of high density lipoprotein (HDL) cholesterol is a sensitive index of coronary heart disease (CHD) risk in Caucasians there is little evidence for differences in HDL levels between populations with low and high prevalence of CHD. This study compares the concentrations of apolipoprotein AI, the major HDL protein, in South Pacific Islanders of different ethnic origin. In two rural populations on Ouvea, the mean AI levels were 94 and 91 mg/dl, respectively, for Melanesian and Polynesian men. These values are substantially lower than in a group of Australian men (120 20 mg/dl). A further comparison between rural and urbanized Polynesian males in Western Samoa showed that urbanization led to higher AI levels (117 mg/dl in the town versus 94 mg/dl in the village). A survey of factors that influence HDL levels suggests that the higher AI levels were due to changes in diet, including fat and alcohol consumption. The prevalence of probable CHD in Western Samoan men aged 40–69, determined by electrocardiography, was about half that reported in an Australian survey. Thus the lower AI levels in the Western Samoan men appeared not to be related to the prevalence of CHD which was less than among Australians who have higher HDL concentrations.