Hyperlipoproteinemia Type Research Articles

Detection and characterization of hyperlipoproteinaemia in middle-aged men.

Serum lipoprotein (LP) concentrations were determined and LP patterns were classified in 261 middle-aged men, recruited from a health examination survey, with serum lipid values above the 80th percentile of the same population. Individuals with hyperlipoproteinaemia (HLP) and normolipidaemic controls were characterized also regarding family history of cardiovascular disease, socio-economic factors and clinical and laboratory variables. Subjects with HLP type IV-V and IIB were overweight and showed hyperuricaemia and hyperinsulinaemia compared with normolipidaemic controls and subjects with HLP type IIA. The latter showed elevated erythrocyte sedimentation rate. In spite of being overweight, subjects with HLP type III showed normal fasting values of insulin and uric acid in serum and normal early insulin response to intravenous glucose. The glucose tolerance did not differ significantly between the groups. Men with HLP types IV-V had predominantly sedentary occupations, in contrast to those with type IIA. There were significantly more smokers in the groups with HLP type IIB and IV-V than in the control group. Thus, individuals with different types of HLP tend to show different metabolic profiles but also different socioeconomic and clinical patterns, suggesting that exogenous factors are of importance in the expression of the LP abnormalities.

Dietary and Drug Treatment of Hyperlipidaemia

83 middle-aged men with different types of hyperlipoproteinaemia were recruited from a health examination survey. They were treated with diet for 3 months and with diet and drugs in combination over a 2-year period (63 men used drugs). The serum lipid reductions after the dietary period were 14% and 27% for serum cholesterol and triglycerides, respectively. After 2 years the corresponding reductions were 21% and 42%, indicating an additional effect of diet and drugs. There was an average body weight reduction of 4.3% during the first 3 months which was maintained over the 2-year period. Special considerations in treating asymptomatic individuals are discussed.

Primary Hyperlipoproteinaemia in a Danish Family

A Danish family consisting of 80 persons, 72 between the ages of 3 and 70 years, was examined for the presence of primary hyperlipoproteinaemia (HLP), resulting in the finding of types II A (8 cases), II B (4 cases), III (2 cases), IV (5 cases), and V (2 cases). The pedigree of the family is presented together with lipid data and HLP type. Five cases of the so-called 'sinking pre-beta midband', which can often be correlated to ischaemic heart disease, have been found using polyacrylamide gel electrophoresis (PGE); two of these subjects had arteriosclerotic disease, one had uratic arthritis, while the other two were normal. A comparative evaluation of the results of electrophoresis should be considered of greater importance when studying families, rather than individual persons, inasmuch as intra-familial lipid patterns appear to occur with a positive correlation to at least serum cholesterol. Continued observation will probably reveal a lipid abnormality characteristic for the family even though according to the reference material available it must be considered as normal.

Very low density lipoproteins in normal and cholesterol-fed rabbits: lipid and protein composition and metabolism: Part 1. Chemical composition of very low density lipoproteins in rabbits

The lipid and apoprotein composition of very low density lipoproteins (VLDL) ( d < 1.019 g/ml) from normal and hypercholesteremic (h.c.) rabbits are compared. Significant changes are observed in the apoproteins, as well as in the fatty acid composition of cholesterol esters, and in the relative distribution of phospholipids. Apoproteins show a marked increase of peptides with slow mobility (R2 and R3), corresponding to arginine-rich proteins, both in the rabbit and in some types of human hyperlipoproteinemias (hypothyroidism and Fredrickson Type III). VLDL were separated into the two fractions, VLDL-1 and VLDL-2. Peptides of slow mobility were shown to be present in a higher concentration in VLDL-1. Cholererol esters of h.c. VLDL have a very high content of oleic acid, the 18 : 1/18 : 2 ratio being about three times higher than in normal VLDL. Phospholipid distribution in h.c. VLDL is characterized by an increase of sphingomyelin and decrease of phosphatidylethanolamine. The PC/Sph ratio is about one fifth that of normal. These changes in VLDL lipids are very similar to those occurring in the lipid composition of the atherosclerotic plaques in mammals.

Cerebrotendinous cholestanolosis in relation to other cerebral xanthomatoses

A synopsis is given of 37 reported patients with cerebrotendinous xanthomatosis; divided in 11 possible, but not proven cases of C.T.Ch (cerebrotendinous cholestanolosis), and 26 proven cases. An increased content of cholestanol in serum or tissue, was used as the main criterion. The ophthalmological and neurological signs are tabulated. Attention is drawn to the fact that cholestanol is not mentioned in the extensive literature on related diseases with possible cerebrospinal xanthomas, such as eosinophilic granulomatosis and hyperlipoproteinemia. The importance of a possible role of cholestanol in these diseases is stressed. A hypothetical form of cerebrotendinous cholesterolosis is discussed. A family with a sibship of parents and twelve children, three of which showed C.T.Ch is described. The development of the clinical picture confirmed the variable expression of the autosomal recessive disease. Two patients showed disturbances of steroid metabolism. A first contribution to the search for linkage with the H.L.A. system is presented. Cholestanol over cholesterol ratio, appeared to be independent of the type of lipoprotein. In search for therapy we found in patients with hyperlipoproteinemia type II A, that cholestyramine alone gave dangerously high blood levels of cholestanol; in combined treatment of cholestyramine with clofibrate cholestanol, levels were comparable to those of the controls. The possibilities of therapy are discussed.

Effect of Treatment with a Bile-sequestering Agent (Secholex®) on Intestinal Absorption, Duodenal Bile Acids, and Plasma Lipids

Four female and five male patients (mean age 26 years) with hyperlipoproteinaemia type II A were treated with an anion exchange gel (Secholex) 9 g/day for 3 months and 15 g/day for 9 months. After these 12 months clofibrate 1.5 g/day was added to the therapy in 6 patients, whereas 2 patients continued with the resin alone for another 6 months, and one was withdrawn from the trial because of pregnancy. During the first year plasma cholesterol decreased averagely 18% from a mean pretreatment value of 461 mg/100 ml. Dosis of 9 g/day seemed to be as efficient as 15 g/day. When clofibrate was added, a further decrease of plasma cholesterol by 6% was observed, and the levels of triglycerides were reduced. Significantly increased concentrations of bile acids and a rise in the glycine/taurine ratio in duodenal aspirate were caused by the resin. On combined treatment the concentration of bile acids decreased to the pretreatment values, whereas the glycine/taurine ratio remained unchanged. During the trial slight transient changes in serum folic acid, fasting insulin, calcium, alkaline phosphatases, and vitamin B 12-absorption occurred. No changes in serum vitamin A, vitamin-K-dependent clotting factors, serum gastrin, gastric acid output, the absorption of glucose and iron, and faecal excretion of fat were observed. Serum insulin 30 and 60 minutes after an oral glucose loading decreased in the patients on combined treatment, whereas the insulin response remained normal in patients taking Secholex alone. Liver function tests and creatinine were unchanged during the trial. Apart from transient abdominal discomfort in two patients, no side-effects were discovered. The patients found the gel palatable.

Lipid and protein contents of low density lipoproteins (LDL) from patients with various types of hyperlipoproteinemia

Lipid and protein contents of low density lipoproteins (LDL) from patients with various types of hyperlipoproteinemia

Serum levels of thyroid-stimulating hormone in hyperlipoproteinemia

Similar serum lipoprotein abnormalities have been demonstrated in hyperlipoproteinemia type III and hypothyroidism. In this study the levels of thyroid-stimulating hormone in serum were determined in clinically euthyroid patients with different types of hyperlipoproteinemias and in subjects with a normal lipoprotein pattern. The mean value for thyroid-stimulating hormone was significantly higher in the group with hyperlipoproteinemia type III than in normal controls ( p < 0.01) and in the group with hyperlipoproteinemia type II A ( p < 0.02). The levels of thyroid-stimulating hormone were positively correlated to the triglyceride and cholesterol concentration in the very low density lipoprotein fraction and the “III-index”.

Plasma glycosphingolipids in diabetics and normals

In diabetic patients with hyperlipoproteinemia type IV the monohexosyl ceramide concentration in blood plasma is significantly elevated. This augmentation can be attributed to an increased monohexosyl ceramide content of the BLDL plasma fraction. In contrast, the di-, tri-, the tetrahexosyl ceramide levels remain within normal limits. In normolipidemic diabetics of comparable age, sex, and weight classes and of comparable metabolic control no elevations of glycolipid fractions could be found. However, patients with primary hyperlipoproteinemia type IV show an increase of monohexosyl ceramide concentrations in blood plasma. Therefore, the augmentation of monohexosyl ceramide levels in plasma of hyperlipidemic diabetic patients seems rather a metabolic consequence of hyperlipoproteinemia than of diabetes per se. A clearcut explantation for the monohexosyl ceramide elevations in the studied groups cannot be given at present time.

Conversion of Type III Hyperlipoproteinaemia to Type IV Hyperlipoproteinemia by a Fat‐Free, Carbohydrate Rich Diet

Abstract. Hyperlipoproteinaemia type III has been considered a clear cut clinical entity characterized by the presence of cholesterol rich “floating” beta very low density lipoproteins (VLDL) after ultracentrifugation. Carbohydrate inducibility is pronounced in type III. This study was undertaken to elucidate the effect of a high carbohydrate diet in type III as an effort to clarify a suggested association between type III and IV hyperlipoproteinaemia. On an isocaloric fat free carbohydrate rich diet the lipoprotein pattern changed as the VLDL triglycerides increased 31 per cent on average and LDL and HDL cholesterol decreased by 40 and 22 per cent. The high ratio cholesterol/triglycerides in VLDL was normalized. The lipoprotein levels in serum after carbohydrate induction showed all characteristics of a type IV with high VLDL triglycerides, normal cholesterol/triglyceride ratio in VLDL, subnormal cholesterol levels in LDL and HDL with changed relation between LDL1 and LDL2. On electrophoresis the floating beta band disappeared. It is probable that depending on the nutritional situation, the metabolic defect in type III may be expressed either as a type III or a type IV. An explanation of the effects of the carbohydrate rich diet on the lipoprotein pattern is suggested.

Quantitative and qualitative serum lipoprotein analysis: Part 2. Studies in male survivors of myocardial infarction

The fasting concentration of cholesterol and triglycerides in serum and in very low (VLDL), low (LDL) and high (HDL) density lipoproteins (LP) was determined 3 months after a myocardial infarction (MI) in 54 men, and the values obtained were compared to those in 61 healthy male control subjects. The mean triglyceride concentration in MI patients was significantly increased in serum, VLDL, LDL and HDL by 74 %, 110 %, 30 % and 12 % respectively, compared to controls. The mean cholesterol concentration was significantly raised by 16 %, 120 % and 14 % in serum, VLDL and LDL but decreased by 22 % in HDL. Hypertriglyceridaemia occurred in 58 % of MI patients. Of these patients, two-fifths had hypertriglyceridaemia only and three-fifths had combined hyperlipidaemia. The hypertriglyceridaemia was caused by elevation of only VLDL triglycerides in 26 %, only LDL triglycerides in 19 %, VLDL and LDL triglycerides in 23 % and by various other combinations of raised LP triglyceride levels in 25 % of cases. Hypercholesterolaemia was found in 41 % of MI subjects. Of these, one-sixth had elevation of cholesterol levels, while five-sixths had combined hyperlipidaemia. The LP abnormalities underlying hypercholesterolaemia were increased of only VLDL cholesterol levels in 36 %, only LDL cholesterol in 14 % and both VLDL and LDL cholesterol in 50 % of cases. The low HDL cholesterol values in comparison to controls were related to higher VLDL triglyceride values in MI patients, since HDL cholesterol fell significantly with increasing VLDL triglyceride levels. When HDL cholesterol was related to similar VLDL triglyceride levels, there were no major differences between controls and MI. It was impossible to determine the type of hyperlipoproteinaemia solely from determination of patients' fasting cholesterol and triglycerides. All 4 lipid groups (normal lipids, elevation of cholesterol levels, elevation of triglyceride levels and elevation of both lipid levels) each comprised at least 2 different types of hyperlipoproteinaemia. Upon LP analysis, the mixed hyperlipidaemic group (elevation of both cholesterol and triglyceride levels) was, as expected, found to be most complex and was comprised of subjects with normal LP levels (11 %), and those with Type IIA (26 %), Type IIB (31 %), Type IV (20 %) and Type III hyperlipoproteinaemia (11 %). In addition, LP abnormalities (Type IIA and others) were found in MI patients with normal total serum lipids. Thus, 38 % of MI had normal lipid levels but only 17 % were normal when all LP classes were considered. The modified Fredrickson system for categorising types of hyperlipoproteinaemia did not cover all LP abnormalities encountered in the MI population. One such abnormality not defined under the present system was the elevation of LDL triglyceride levels, an important cause of hypertriglyceridaemia alone or in combination with raised triglyceride levels in other LP classes. LDL hypertriglyceridaemia occurred with or without simultaneous elevation of LDL cholesterol levels. The importance of quantitative LP analysis in the correct diagnosis of hyperlipidaemia and in the evaluation of the presence of hyperlipoproteinaemia is stressed.

Uric acid concentration in serum in different types of hyperlipoproteinemia, myocardial infarction and primary gout

Uric acid concentration in serum in different types of hyperlipoproteinemia, myocardial infarction and primary gout

Triglyceride, free fatty acid and carbohydrate metabolism in hyperlipaemic (type IV) and normolipaemic subjects on carbohydrate- of fat-rich diets.

1. Five patients with hyperlipoproteinaemia type IV and five normolipaemic controls were maintained on diets containing either a fat or a carbohydrate content of approximately 60%. Leg exchanges of triglycerides, free fatty acid (NEFA), glucose and other metabolites were measured in the basal state. The metabolic response to an intravenous glucose load and the turnover of intravenously infused (14C)oleic acid were determined. Individual fatty acids were analysed in plasma NEFA and very-low-density lipoprotein triglyceride. 2. No differences were detected between patients and controls with regard to leg uptake of triglyceride or NEFA on either diet. On shifting from a fat-rich to a carbohydrate-rich diet, the control subjects showed reduced values for arterial NEFA and for NEFA turnover, accompanied by a lowered release of NEFA and glycerol from the leg. In patients, on the other hand, the arterial concentration and turnover of NEFA remained unchanged and the release of glycerol from the leg increased. Glucose administration gave a less-pronounced fall of arterial NEFA on either diet in the patients and the incorporation of (14C)oleic acid into triglycerides after glucose administration was more marked than in the controls. 3. No difference in net uptake of triglyceride by the leg was demonstrable between patients and controls. 4. it is concluded that hyperlipaemic patients show an altered metabolic response to a carbohydrate-rich diet, possibly contributing to the development of a hyperlipaemic state, and that acute glucose loading results in a greater incorporation of circulating NEFA into very-low-density lipoproteins in these patients.

Radioimmunoassay of human plasma apolipoproteins: Part 1. assay of apolipoprotein-B

A specific radioimmunoassay for apolipoprotein-B, the dominant apoprotein of human plasma β-lipoprotein, is described. The antigen for the assay was a narrow density sub-class of β-lipoprotein (density 1.020–1.050), labelled with 125I, and the antibody was produced by immunisation of the rabbit. Bound and free fractions were separated using a double antibody precipitation technique. The absolute lower limit of sensitivity was approximately 5 ng protein, with a working range of from 10 to 200 ng. Dilutions of plasma and various lipoprotein fractions displaced labelled β-lipoprotein in a parallel fashion to the standard curve, demonstrating specificity of the assay for apo-B. There was limited cross-reactivity with monkey serum. Apoprotein-B was undetectable in a-β-lipoproteinaemia serum. Mean plasma apo-B concentration (± I S.D.) in healthy subjects was 90 ± 24 mg/100 ml, with a positively skewed distribution. Concentrations of apo-B were increased in all types of hyperlipoproteinaemia. There was a significant positive correlation between plasma apo-B and plasma cholesterol concentrations. In health, 94 % of total plasma apo-B was confined to β-lipo-protein but there was a shift to pre-β-lipoprotein in hypertriglyceridaemia.

Serum pseudocholinesterase and ceruloplasmin in various types of hyperlipoproteinemia

Starting from previous observations emphasizing an increased pseudocholinesterase (PCE) activity in obese and hyperlipemic subjects, the behaviour of this enzyme and of ceruloplasmin was studied in connection with changes of serum lipids and lipoproteins in various types of hyperlipoproteinemia. When compared to values detected in 67 middle-aged normal weight normolipemic subjects, PCE activity was found to be significantly greater ( p < 0.001) in the 49 overweight subjects without obvious hyperlipemia but presenting a moderate increase of the prebeta electrophoretic fraction. PCE activity was much higher in lean or overweight subjects with endogenous hypertriglyceridemia (68 patients with type IV and 86 patients with mixed hyperlipemia). The slight increase of mean values of PCE activity in the 53 subjects with type II-a was due mainly to overweight subjects, while this enzyme's activity was not significantly changed in lean subjects with pure hypercholesterolemia. PCE activity was positively correlated with serum triglyceride ( r = 0.540; p < 0.001) and the prebeta electrophoretic fraction ( r = 610; p < 0.001). The correlation with beta-lipoproteins was not significant. Ceruloplasmin levels were not significantly changed. It is suggested that elevation of PCE activity could be connected to mechanisms leading to an increased secretion rate of lipoproteins.

Conversion of Type III Hyperlipoproteinaemia to Type IV Hyperlipoproteinaemia by a Fat‐Free, Carbohydrate Rich Diet

Hyperlipoproteinaemia type III has been considered a clear cut clinical entity characterized by the presence of cholesterol rich "floating" beta very low density lipoproteins (VLDL) after ultracentrifugation. Carbohydrate inducibility is pronounced in type III. This study was undertaken to elucidate the effect of a high carbohydrate diet in type III as an effort to clarify a suggested association between type III and IV hyperlipoproteinaemia. On an isocaloric fat free carbohydrate rich diet the lipoprotein pattern changed as the VLDL triglycerides increased 31 per cent on average and LDL and HDL cholesterol decreased by 40 and 22 per cent. The high ratio cholesterol/triglycerides in VLDL was normalized. The lipoprotein levels in serum after carbohydrate induction showed all characteristics of a type IV with high VLDL triglycerides, normal cholesterol/triglyceride ratio in VLDL, subnormal cholesterol levels in LDL and HDL with changed relation between LDL1 and LDL2. On electrophoresis the floating beta band disappeared. It is probable that depending on the nutritional situation, the metabolic defect in type III may be expressed either as a type III or a type IV. An explanation of the effects of the carbohydrate rich diet on the lipoprotein pattern is suggested.

Studies in Asymptomatic Primary Hyperlipidaemia

Among approximately 20,000 apparently healthy subjects whose serum cholesterol and triglyceride (TG) values were screened at a health examination, those with the most pronounced hyperlipidaemia have been selected for further studies. Thus, 188 males and 126 females, aged 30-65 years, with asymptomatic primary hyperlipoproteinaemia (HLP) and 59 male and 69 female controls with non-elevated serum lipids were studied with regard to frequency of ST segment depressions during exercise to near maximal heart rate. Furthermore, the concentrations of cholesterol and TG were determined in the lipoprotein (LP) classes very low (VLDL), low (LDL) and high (HDL) density LP, separated by preparative ultracentrifugation. From the LP analysis each subject's HLP was classified according to the typing system of HLP recommended by the WHO. The frequency of ST depressions (Minnesota code 4.1-4.3 as well as 4.1-4.4) increased with age, was higher in females than in males and was increased in all types of HLP in males. The percentage frequencies of ST depressions 4.1-4.4 in the various types of HLP were (male/female, p against controls): controls 16/36, type IIA 50 (p less than 0.01)/56, type IIB 64 (p less than 0.01)/75 (p less than 0.01)/75 (p less than 0.05), type III 67 (p less than 0.01)/33 and type IV HLP 40 (p less than 0.01/53. There was no significant difference in the frequencies of ST depressions in subjects with "high" and "low" BP (hypertensives were excluded from the study) or in subjects with "high" and "low" k-value for the i.v. glucose tolerance. Non-smokers had a tendency to higher frequencies of ST depressions than smokers. The association between different LPs and other "risk factors" and the occurrence of ST depressions in HLP were studied further with multiple regression analysis. Invariably age was the best predictor of ST depressions. The LP fraction giving the highest correlation coefficient was LDL cholesterol in both sexes. VLDL TG and LDL TG were also positively and significantly associated with ST depressions. HDL cholesterol was negatively but insignificantly correlated to ST depressions. When age and LDL cholesterol had been entered into the multiple regression, the only factor giving further significance was VLDL TG in males. Probability tables for the occurrence of ST depressions considering age and different levels of LDL cholesterol and VLDL TG were given. The importance of simultaneous consideration of both VLDL TG and LDL cholesterol in ST segment depression was evident from the tables. Of other "risk factors" (BP, glucose tollerance, smoking, ESR) entered into the regression together with only age and the LPs, only ESR contributed with borderline significance to ST depressions.

STUDIES IN ASYMPTOMATIC PRIMARY HYPERLIPIDAEMIA

A clinical and laboratory examination of abnormalities not attributable to atherosclerosis has been performed on 188 male and 126 female adult subjects with hyperlipidaemia. The sample was recruited from 20000 subjects screened at a health control centre who had an initial serum cholesterol and/or triglyceride (TG) concentration above 350 mg/100 ml and 3.50 mmol/l. All were subjectively healthy and had no history of atherosclerotic disease. Known cases of secondary hyperlipidaemia were excluded. Lipoprotein (LP) analysis with preparative ultracentrifugation and electrophoresis was made on all subjects including control group with "nonelevated" serum lipids. Typing of hyperlipoproteinaemia (HLP) was performed according to the modified system of Fredrickson et al. Compared to controls, subjects who had elevated very low density ?LP (VLDL) (types II B, III, IV and V) were more obsese, while subjectI B and women with type IV HLP than in the control groups. Arcus corneae was seen in 29% of control groups. Arcus corneae was seen in 29% of controls and in higher frequencies in types II A and II B. A positive correlation existed between the frequency of arcus corneae and the mean low density LP cholesterol in the different types. Multiple tendon xanthomata (n equals 11) were found exclusively in type II A HLP, palmar xanthomata (n equals 3) only in the presence of floating beta-LP and eruptive xanthomata in one male with type V HLP. The mean ESR was increased in all types of HLP. The mean S-GPT and uric acid concentrations were higher in type IV HLP in both sexes than in the control groups. In men with type IV HLP S-GPT was positively correlated to tvldl tg. the uric acid level was correlated to both the VLDL TG concentration and body weight independently. Of the male subjects with HLP 1/3-1/2 had a diabetic or borderline i.v. glucose tolerance.

Studies in Asymptomatic Primary Hyperlipidaemia

The occurrence of early signs of peripheral vascular disease (PVD) of the lower limbs has been studied with digital pulse plethysmography in 160 men and 123 women above the age of 35, who were all subjectively healthy but were found to have primary hyperlipoproteinaemia (HLP) at a health control centre. Quantitative analysis of serum lipoproteins with cholesterol and triglyceride (TG) determination of each of the very low (VLDL), low (LDL) and high (HDL) density lipoprotein clases together with lipoprotein paper electrophoresis was performed. Identical investigations were performed on control subjects with non-elevated serum lipids. Inclination time (IT) was substantially prolonged in 12% of HLP males and 7% of HLP females. The frequency of male subjects with prolonged IT was lower when only LDL was elevated (type IIA) than in the other types of HLP. The subjects with prolonged IT had three characteristic features. 1) Moderate elevations of both serum cholesterol and TG. These elevations occurred often in both VLDL and LDL lipoprotein classes. IT prolongations were not seen when VLDL or LDL lipoproteins were singly maredly elevated. 2) High frequency of smokers. 3) Most of the subjects were above the age of 50. The results suggest that the most atherogenic lipoprotein abnormalities to the arteries of the lower limb are on the one hand the relatively TG-rich part of the LDL (LDL1) fraction and on the other hand the relatively cholesterol-rich part of the VLDL fraction. Furthermore the results stress the deleterious influence of smoking even in the preclinical stage of PVD.

Prospective study among male employees in industry. I. Prevalence of hyperlipoproteinemia.

In a primary prevention study performed in an industrial preventive health center in Göteborg, Sweden, 676 male employees, aged 40-67 years, have been screened for the presence of elevated serum lipid/lipoprotein values, and the estimated prevalence of hyperlipoproteinemia (according to the cut points) was 25.8%. The hyperlipoproteinemias were distributed among the three major types, II A, II B and IV, as 12.8, 1.9 and 11.1%, respectively. The incidence of coronary heart disease (CHD) (n = 13), pathologic ECG at rest (n = 42), elevated systolic or diastolic BP, and overweight were compared between 128 males with hyperlipoproteinemia and 100 matched normolipidemic controls from the same population. Hyperlipoproteinemia type IV was most common in males aged 50 (48-52) years. In type IV the mean systolic BP was higher (p less than 0.05) than in the controls and overweight was more frequent, particularly in males aged 50 (p less than 0.05). There were, however, no statistically significant correlations among the variables, serum lipids (cholesterol and triglycerides), BP (systolic or diastolic) and body weight (expressed in relation to height) in type IV. CHD (p less than 0.01) were more common among males with hyperlipoproteinemia than in the controls. The data from the present and earlier studies suggest that hyperlipoproteinemia should be looked for in particular among males aged 50, among males with elevated systolic BP and/or overweight, as well as among males already presenting signs or symptoms of CHD or a pathologic ECG.