Prevalence and effects of nonpharmacologic treatment of "isolated" low-HDL cholesterol in patients with coronary artery disease.

Abstract

To determine the the prevalence of isolated low high-density lipoprotein cholesterol and its response to hygienic therapy in coronary patients after major cardiac events. Data before and after phase II cardiac rehabilitation and exercise training were assessed in 275 consecutive patients from two institutions. All patients had known coronary artery disease and underwent a 12-week program of aggressive hygienic therapy. The prevalence of isolated low high-density lipoprotein cholesterol in this cohort was determined and its response to vigorous nonpharmacologic therapy was assessed and compared with that of other coronary patients undergoing similar therapy. At baseline, 113 (41%) had low high-density lipoprotein cholesterol, including 70 (25%) with isolated low high-density lipoprotein cholesterol. In contrast, 147 (53%) had "high-risk" low-density lipoprotein-cholesterol > or = 130 mg/dL. In the subgroup with isolated low high-density lipoprotein cholesterol, improvements occurred in body mass index, metabolic equivalents, high-density lipoprotein cholesterol, and low-density lipoprotein/high-density lipoprotein cholesterol. Compared with 205 patients without isolated low high-density lipoprotein cholesterol, this subgroup had much greater improvements in high-density lipoprotein cholesterol (+17% versus +2%; P < .001) and low-density lipoprotein/high-density lipoprotein cholesterol (-11% versus -6%; P < .02), with similar improvements in most other major coronary artery disease risk factors. These results suggest that isolated low high-density lipoprotein cholesterol is prevalent in patients with coronary artery disease and is sensitive to aggressive hygienic interventions.