Lipid Research Clinics Program Prevalence Research Articles

Micronutrient intakes in two us populations of older adults: Lipid research clinics program prevalence study findings

Dietary intakes of several minerals and vitamins were assessed in two US sub-populations of older men and women between 60 and 80 years as part of the Lipid Research Clinics Program Prevalence Study conducted in the mid-1980s prior to widespread fortification. Dietary intakes were analyzed from 24-hour recalls using the Minnesota Nutrition Coding Center. Descriptive statistics on the two diverse sub-populations were generated for the elderly subjects at the two clinic sites, southern California and Oklahoma. Regression analyses of specific micronutrients were performed while controlling for several variables, namely, age, sex, clinic (region), education, Body Mass Index (BMI), alcohol consumption, and smoking status. Compared to current (1999–2004) Estimated Average Requirements (EARs) and Adequate Intakes (AIs) for three micronutrients without EARs for the US and Canada, several micronutrients were consumed at or close to their EAR values. Exceptions include intakes of vitamin A, vitamin E, folic acid, potassium and calcium which were very low; intakes of thiamin, riboflavin, niacin, and vitamin C were low but closer to the published EAR or AI values. High intakes approaching cut-offs for practically all subjects were found for both groups of elders at the two clinic sites for iron, phosphorus, and sodium. In general, California elderly had somewhat better consumption patterns for the vitamins, but the Oklahomans, males at least, had higher overall mineral intakes. The micronutrient deficits found in this small study suggest that most elderly US citizens were likely to be deficient in five micronutrients and marginally insufficient in four others in the mid-1980s and, despite even greater fortification currently, elderly intakes seem not to have improved substantially since the 1980s, except for subjects who are regular multi-supplement users.

Micronutrient intakes in two us populations of older adults: Lipid research clinics program prevalence study findings

Micronutrient intakes in two us populations of older adults: Lipid research clinics program prevalence study findings

Sex and race differences in cardiovascular disease risk factor changes in schoolchildren, 1975-1990: the Princeton School Study.

This study was done to assess changes in obesity and risk factors for cardiovascular disease (CVD) in Black and White children from 1975 through 1990. A cross-sectional study of body composition and CVD risk factors conducted in a school district as part of the Lipid Research Clinics (LRC) Program Prevalence Study (1973-1975) was compared with a later study (1989-1990) conducted in the same school district, which remained demographically stable. The studies included 1456 third- and fifth-grade students and 300 LRC subjects within the same age ranges. Students in the 1989-1990 study had a significantly higher mean body mass index (BMI), total blood cholesterol concentration, and systolic and diastolic blood pressures and marginally higher resting heart rates than those in the earlier study. The prevalence of obesity increased from 12.5% to 25.3%, and of hypercholesterolemia from 8.0% to 14.8%. Black females had the largest increase in BMI and resting heart rate and the highest prevalence of elevated total cholesterol in the 1989-1990 study. The results of this study suggest a secular trend toward increased obesity in children and portend the potential development of a public health problem that could reverse the recent decline in morbidity from CVD.

Poland-US collaborative study on cardiovascular epidemiology: classification agreement between US National Cholesterol Education Program and European Atherosclerosis Society hyperlipidemia guidelines in selected Polish and US populations

Data from two epidemiological studies are used to measure the degree to which two well-known guidelines agree in measuring hyperlipidemia in population samples in the US and Poland. The epidemiological studies are the US Lipid Research Clinics Program Prevalence Study and the Pol-MONICA project in Poland and the guidelines are those adopted by the US National Cholesterol Program (USNCEP) and by the European Atherosclerosis Society (EAS). EAS guidelines were analyzed in two ways: Method 1 used triglycerides and total cholesterol only in classifying persons as hyperlipidemics or non-hyperlipidemics; Method 2 used triglycerides, total cholesterol and nine additional risk factors in the classification process. USNCEP guidelines used total cholesterol, low density lipoprotein cholesterol and the same additional nine risk factors used in EAS Method 2 in classifying hyperlipidemics. Classification differences between the two sets of guidelines were high when EAS Method 1 guidelines were compared with USNCEP guidelines. However, EAS Method 2 which included risk factors, compared favorably with USNCEP guidelines in all three populations under study.

Screening for total cholesterol. Do the National Cholesterol Education Program's recommendations detect individuals at high risk of coronary heart disease?

The National Cholesterol Education Program (NCEP) has provided guidelines for identification of persons at high risk of coronary heart disease (CHD) because of lipid abnormalities. These recommendations are based on total cholesterol as the initial screening tool and have become the stimulus for clinic- and community-based screening programs nationwide. However, the use of the guidelines may be problematic because individuals may have total cholesterol levels in the desirable range but low density lipoprotein (LDL) or high density lipoprotein (HDL) levels considered at high risk. This study evaluates the ability of the NCEP screening recommendations to identify correctly persons at high risk of CHD because of lipid abnormalities. Using the NCEP guidelines, we simulated a population-based screening program with data from visits 1 and 2 of the Lipid Research Clinics Program Prevalence Study. Individuals were considered to be at high risk of CHD if they had LDL levels greater than 160 mg/dl or HDL levels less than 35 mg/dl. Following the NCEP process, 21% of those with high LDL concentrations and 66% of those with low HDL concentrations would not be routinely referred for immediate treatment. Overall, 41% of those at high risk of CHD would not be promptly evaluated. The sensitivity of the guidelines for promptly identifying individuals with lipoprotein abnormalities is 59%. This relatively low sensitivity of total cholesterol as a screening tool should be the impetus for rethinking the screening guidelines. Specifically, the cost-benefit ratio of routine screening for lipoproteins, particularly HDL cholesterol, needs to be carefully considered.

Black-white differences in exercise blood pressure. The Lipid Research Clinics Program Prevalence Study.

After exclusion of persons on blood pressure medication or with prevalent cardiovascular disease, we studied 83 black and 2,548 white men and 113 black and 1,519 white women 20-69 years old from the Lipid Research Clinics population sample who had performed a standardized treadmill exercise test. Resting systolic and diastolic blood pressures were similar in black and white men, but the diastolic pressure was significantly higher in black than in white women (81.4 vs 77.4 mm Hg). Body weight was higher in black than in white women, and reported physical activity was higher in black than in white men. The proportion of smokers was somewhat higher in blacks than in whites. During the treadmill exercise test with a modified Bruce protocol, mean systolic blood pressure at stage 2 was 174 mm Hg in black men and 166 mm Hg in white men (p less than 0.02), but stage 2 blood pressures did not differ between black and white women (153 and 152 mm Hg, respectively). Even after adjustments were made for levels of baseline characteristics (age, weight, resting systolic blood pressure, smoking, low density lipoprotein cholesterol, physical activity, and alcohol intake), black men responded with a 7-mm Hg higher systolic blood pressure during exercise than white men (p less than 0.01). Another new finding was a highly significant positive association between stage 2 systolic blood pressure and low density lipoprotein cholesterol in men. The findings suggest a higher systemic vascular resistance during exercise in the selected sample of black men, which is consistent with the higher incidence of hypertension in black men.

Contrasting diet and body mass among users and nonusers of oral contraceptives and exogenous estrogens: the Lipid Research Clinics Program Prevalence Study.

Mean dietary constituent levels using the 24-hour recall method and body mass measures were examined among oral contraceptive and exogenous estrogen users and nonusers in the Lipid Research Clinics Program Prevalence Study. Among women aged 20-44 years, oral contraceptive users had a significantly lower mean Quetelet index of body mass and triceps skinfold thickness and a significantly higher total caloric intake. Among women aged 45-69 years, those taking exogenous estrogens had a significantly lower mean Quetelet index. No significant differences between hormone users and nonusers were seen for per cent of calories from fat (saturated or unsaturated), protein, carbohydrates, starch, sucrose, or alcohol. The higher total caloric intake in oral contraceptive users in contrast to nonusers and the lower body mass in both groups of gonadal hormone users may in part be indicative of other differences in life-style and behavior between the study groups. Further documentation of specific eating patterns, nutrient intake, and energy metabolism in women consuming gonadal hormones and in suitable control subjects seems to be indicated.

THE PREVALENCE AND CORRELATES OF ROSE QUESTIONNAIRE ANGINA AMONG WOMEN AND MEN IN THE LIPID RESEARCH CLINICS PROGRAM PREVALENCE STUDY POPULATION

The prevalence and correlates of Rose Questionnaire angina were investigated in a sample of 4,661 white woman and men aged 30 years and above who participated in the Lipid Research Clinics Program Prevalence Study 1972-1976. Among men, the prevalence of Rose angina increased with age from about 1% to 12%, while the prevalence among women ranged from about 3% to 6%. Young women compared with men also had a relatively high prevalence of dyspnea, which was strongly correlated with Rose angina in both sexes. For women and men younger than 50 years, the dyspnea-Rose angina odds ratio was about 6 (p less than 0.001), while older women and men had somewhat lower sand higher odds ratios, respectively. Major and minor resting electrocardiographic abnormalities and self-reported history of a heart attack were not significantly associated with Rose angina among young participants of either sex, but they did show positive associations among older participants with the exception of minor electrocardiographic abnormalities in men. A logistic regression analysis revealed a strong inverse association between high density lipoprotein cholesterol and Rose angina in both sexes. Because mortality studies consistently show an excess of coronary heart disease death among young men compared with women, the female excess of Rose angina at young ages suggests that the grouping of angina and myocardial infarction into a single endpoint in cardiovascular disease studies may be more appropriate for young men than for young women.

Prevalence and clinical correlates of beta-migrating very-low-density lipoprotein: Lipid research clinics program prevalence study

The prevalence and clinical associations of beta-migrating very-low-density lipoprotein (beta-very-low-density lipoprotein), an atherogenic lipoprotein associated with type III hyperlipidemia, were compared in men and women using and not using estrogen-containing hormones. Beta-very-low-density lipoprotein was more common in men, 0.54 percent or one in 185, than in women not taking hormones, 0.30 percent or one in 333, and was least common in women taking hormones, 0.04 percent or one in 2,500. Beta-very-low-density lipoprotein-positive men and women were heavier and had higher triglyceride, cholesterol, and very-low-density lipoprotein cholesterol levels compared with beta-very-low-density lipoprotein-negative subjects, but 30 percent of the men and 21 percent of the nonuser women did not have elevated triglyceride or cholesterol levels. The very-low-density lipoprotein cholesterol/total triglyceride ratio exceeded 0.30 in 55 percent and 54 percent of beta-very-low-density lipoprotein-positive men and women compared with 3.3 percent and 3.9 percent of beta-very-low-density lipoprotein-negative men and women. Ninety-three percent of the beta-very-low-density lipoprotein-positive subjects had some lipoprotein lipid abnormality and 60 percent had an abnormal glucose, liver, or renal function test result or high alcohol or dietary cholesterol intake. In conclusion, beta-migrating very-low-density lipoprotein is more common in men than in women, consistent with a protective effect of estrogen. About half of the time, beta-very-low-density lipoprotein is associated with an elevated very-low-density lipoprotein cholesterol/total triglyceride ratio, indicating that beta-very-low-density lipoprotein can be present independent of other markers of type III hyperlipidemia. Nonetheless, beta-very-low-density lipoprotein signifies abnormal lipoprotein metabolism of some kind in almost every instance, is frequently associated with treatable medical conditions, and may on pathophysiologic grounds be considered important in its own right in predicting atherosclerosis risk. Beta-very-low-density lipoprotein-associated conditions should attract medical attention.

Effect of estrogen/progestin potency on clinical chemistry measures. The Lipid Research Clinics Program Prevalence Study.

The effects of oral contraceptives of varied estrogen/progestin composition on clinical measurements of hepatic, thyroid, and renal function and carbohydrate metabolism were examined in 1,355 women in the Lipid Research Clinics Program Prevalence Study. In general, bilirubin and alkaline phosphatase levels are lower with both oral contraceptives and postmenopausal estrogen use, suggesting an estrogen effect. The least bilirubin reduction is seen with a progestin dominant oral contraceptive. A significant decrement in aspartate aminotransferase is observed in users of one high estrogen dose oral contraceptive and in postmenopausal Premarin users, while aspartate aminotransferase is higher in postmenopausal users of higher dose ethinyl estradiol. Globulins are slightly higher in all hormone use categories, suggesting an estrogen effect on hepatic secretion of this protein class into the circulation. Fasting glucose concentrations are generally slightly lower even in the progestin dominant oral contraceptives, where glucose intolerance has been described. Thyroxine concentrations are generally elevated in all women using oral contraceptives. A relationship to estrogen dose is seen in women with thyroxine concentrations greater than the 99th percentile and in postmenopausal estrogen users. Creatinine concentration is greater with the use of Ovral, a progestin dominant oral contraceptive, and lower with two estrogen dominant oral contraceptives and Premarin, suggesting a competitive effect of estrogen and progestin. Among the clinical laboratory tests considered here, oral contraceptive effects seem to be largely estrogen mediated with a suggestion of competitive effect of estrogen versus progestin only on bilirubin and creatinine levels. These observations differ from lipoproteins where opposing hormonal effects are more clearly reflected in changing lipoprotein concentrations.

Comparison of plasma lipids, lipoproteins and dyslipoproteinemia in Israel and the United States: The lipid research clinics program prevalence study

Based on the common study design, protocol, and laboratory techniques used by the Lipid Research Clinics (LRCs), the study reported here compared the adult study populations examined by the U.S. LRCs and the LRC located in Jerusalem, Israel. A number of 2 388 residents of Jerusalem were contrasted with 6 528 examinees of the U.S. LRCs regarding their plasma lipid and lipoprotein cholesterol distributions. Marked differences between the U.S. and Jerusalem LRCs were observed in the plasma levels of lipids and lipoprotein cholesterol fractions. Mean total cholesterol concentrations were 2–8% higher in the U.S. compared to the Jerusalem sample. Low density lipoprotein cholesterol levels were higher by approximately 5–15% in the U.S. LRCs, a phenomenon more marked in men than women and in older compared to younger study participants. High density lipoprotein cholesterol values were also higher in the U.S. compared to the Jerusalem LRC, by approximately 10–14% in men and women. These differences were also more pronounced in older compared to younger participants. By contrast, median plasma total triglycerides (and by implication very low density lipoprotein cholesterol) were higher in the Jerusalem compared to the U.S. study participants. This difference ranged from 10–21% by age and sex. The correlations between the plasma lipid/lipoprotein measurements were similar in the two study populations. Only the degree of linear association between plasma total triglyceride and very low density lipoprotein cholesterol was different between the U.S. and Jerusalem, with a correlation coefficient of greater magnitude in the latter. Employing common cutpoints to define dyslipoproteinemia (DLP) observed differences in plasma lipid/lipoprotein distributions determined differences in the frequency of DLP categories between the U.S. and the Jerusalem samples. Higher proportions of Type IV and hypo-HDL were observed in Jerusalem compared to the U.S. By contrast, fewer individuals were classified as Type IIa, Type IIb, and hyper - HDL in Jerusalem relative to the U.S.

Demographic, behavioral, biochemical, and dietary correlates of plasma triglycerides. Lipid Research Clinics Program Prevalence Study.

Few studies have simultaneously examined the relationship of triglyceride levels with a wide variety of potential covariates. Thus, the present study was designed to assess in a large, free-living population the association of fasting plasma triglyceride values with selected demographic, behavioral, biochemical, and dietary measures. These analyses were done using data obtained from 5189 white men and women aged 20 to 69 years who participated in the Lipid Research Clinics Program Prevalence Study. Of the eight nondietary factors examined, age, Quetelet Index, fasting plasma glucose, and cigarette smoking were strongly, positively associated (p less than 0.0001) with triglycerides in men and in women not using gonadal hormones. Among women using oral contraceptives or estrogens, only Quetelet Index (p less than 0.01) and cigarette smoking (p = 0.01) were significantly related to triglyceride values. Physical activity was inversely associated (p less than 0.0001) and use of diuretic medications was positively related (p less than 0.01) to triglycerides only in men. Results of analyses of triglycerides and six selected dietary measures varied by age, sex, and hormone-use subgroups. Although none of the dietary variables showed consistent associations with triglycerides across all of the subgroups, triglycerides tended to be inversely associated with total calories per kilogram of body weight and the percentage of calories as dietary fat.

The ratio of plasma high-density lipoprotein cholesterol to total and low-density lipoprotein cholesterol: age-related changes and race and sex differences in selected North American populations. The Lipid Research Clinics Program Prevalence Study.

The distribution of the ratios of plasma high-density lipoprotein cholesterol (HDL-C) to total cholesterol (TC) and of HDL-C to low-density lipoprotein cholesterol (LDL-C) are presented for 6900 white and 495 black examinees greater than 4 years old. Measurements were obtained during the visit 2 survey of the Lipid Research Clinics (LRC) Program Prevalence Study, and correspond to a 15% random sample of 60,502 participants screened during the LRC visit 1 survey. Age-specific means, medians, and selected percentiles are given by sex and by gonadal hormone use in white women. Apparent in these cross-sectional data was a consistent age-related decline in the ratio of HDL-C to TC for white male participants, from a mean of 0.360 in the age group 5 to 9 to a mean of 0.211 in the age group 50 to 54. Thereafter the mean ratio increased slightly. In white women not using gonadal hormones the age-related decline in the ratio was only evident starting at the age group 35 to 39, from which it declines from 0.329 to 0.258 in the age group 55 to 59. White women using gonadal hormones showed very minor age-related changes in the HDL-C/TC ratio, varying around a mean of 0.300. The number of blacks examined was low and thus the racial comparisons must be interpreted with caution. For each gender, age-related trends were similar in black and white study participants. Black men, however, had a higher percentage of TC carried as HDL-C than white men in all age groups examined. Black women had a higher percentage of TC in HDL-C than white women only below age 20; in the adult age range no appreciable differences were seen. Pearson correlation coefficients between the lipid, lipoprotein, and lipoprotein ratios are presented. The ratio HDL-C/TC correlated highly with the ratio HDL-C/LDL-C (greater than 0.92 for all groups) and the former may be a more conveniently determined surrogate for the latter. Although not exhaustive regarding the information it conveys about a lipid pattern, the ratio HDL-C/TC has the advantage of summarizing complex associations into a single numerical approximation.

U.S.S.R. and U.S. nutrient intake, plasma lipids, and lipoproteins in men ages 40–59 sampled from lipid research clinics populations

Correlates of high-density lipoprotein (HDL) cholesterol and other lipids and lipoproteins were studied in white men ages 40–59 who were part of the 15% random sample recalled to Visit 2 of the Lipid Research Clinics Program Prevalence Study. Standardized examinations were conducted by two U.S.S.R. and nine U.S. clinics. Mean plasma lipid and lipoprotein cholesterol levels differed significantly between the two countries, with the U.S.S.R. subpopulations having higher mean total plasma and HDL cholesterol levels and HDL/total cholesterol ratios and lower mean triglyceride levels and low-density lipoprotein (LDL)/HDL cholesterol ratios than the U.S. subpopulations. Small, but statistically significant, differences were found in some dietary components. The U.S.S.R. sample had a significantly higher intake of saturated fatty acids, carbohydrates, complex carbohydrates, and kilocalories/kilogram body weight and a significantly lower intake of total fat, polyunsaturated fatty acids, protein, and polyunsaturated/saturated fat ratio. The multiple regression models tested were not major predictors for total plasma cholesterol or LDL cholesterol. Characteristics associated with higher HDL cholesterol levels in both countries were lean body mass, ethanol consumption, abstinence from cigarette smoking, and lower dietary consumption of carbohydrates.

Nutrient intakes among selected North American populations in the Lipid Research Clinics Prevalence Study: composition of fat intake

Components of fat and their relationship to total energy are described for 2,368 white male and 2,200 white female adults, aged 20-59 years, for whom 24-hour dietary recalls were completed between 1972 and 1975 in nine North American populations as a part of the Lipid Research Clinics (LRC) Program Prevalence Study. Men had higher absolute intakes of total fat and cholesterol than women, although both sexes consumed diets similar in relative composition of polyunsaturated, saturated, and monounsaturated fatty acids. Marked geographical differences in intakes of energy, total fat, and dietary cholesterol were observed. Compared with data from dietary surveys conducted in the 1960's the LRC data showed that consumption of cholesterol had decreased by the early 1970's, whereas consumption of polyunsaturated fatty acids appears to have increased, resulting in a higher ratio of polyunsaturated to saturated fatty acids. However, comparison of current dietary guidelines with these data, which are based on a single dietary recall, showed that few LRC participants met the recommendations of the Senate Select Committee on Nutrition and Human needs for dietary fat intake.

The constancy of parent-offspring similarity of total cholesterol throughout childhood and early adult life: The Lipid Research Clinics Program Prevalence Study

In a cross-sectional study of 11,409 white parent-offspring pairs in five North American populations we examined the effect of age of the offspring on parent-offspring total cholesterol correlations. In general there were no differences in correlations by age of the offspring for the four types (by gender) of parent-offspring pairs. This was true within each of the five populations and for the average of all populations combined. For offspring from less than 2–29 years of age, these average age-specific correlations ranged from 0.17 to 0.42. Despite the considerable physiologic and environmental changes which influence cholesterol levels from birth to early adulthood, the strength of parent-offspring similarity shows no consistent pattern of change.

Predictors of systolic blood pressure response to treadmill exercise: the Lipid Research Clinics Program Prevalence Study.

We used multiple linear regression to study predictors of systolic blood pressure response (SBPR), i.e., the increase in pressure above baseline after 3, 6, and 9 min of treadmill exercise, in 4262 men and women. Predictors considered were usual SBP, the difference (delta SBP) between resting SBP and SBP immediately before exercise, age, education, obesity index, alcohol consumption, cigarette smoking, preexercise heart rate and, in women, gonadal hormone use. In men, age, obesity index, and cigarette smoking were positively associated with SBPR and in women 20 to 49 years old, age, obesity index, and alcohol consumption were positively associated with SBPR. In women 50 years old or older, usual SBP was negatively associated with SBPR. In both men and women a larger delta SBP was associated with a smaller SBPR. These results help explain the considerable variation in SBPR, and the delta SBP results suggest that potential SBPR may, to certain extent, have a specific, finite range. The similarity of predictor variables for SBPR to predictor variables for hypertension is concordant with the previous observation that a high SBPR may foreshadow subsequent hypertension.

Ischemic Heart Disease Mortality in Iowa Farmers

Analysis of 62,000 deaths in Iowa men aged 20 to 64 years from 1964 to 1978 indicates that Iowa farm men younger than 65 years have lower than expected mortality for all causes and for ischemic heart disease. Using data gathered by the Iowa Lipid Research Clinics (LRC) Program Prevalence Study, we compared levels of known cardiovascular risk factors in farmers with those of nonfarmers residing in the same rural county. Farm men smoked less frequently (19% v 44%) and engaged in exercise more frequently (83% v 40%) than nonfarmers. Treadmill performance in farm men indicates a higher level of fitness in farmers. Farm people consumed more total calories and cholesterol, but drank less alcohol than nonfarmers. Farm men had significantly higher serum cholesterol levels. High-density lipoprotein cholesterol levels were also higher in farmers. However, when adjusted for age and exercise status, farmers and nonfarmers had similar lipid levels. The results of the LRC survey suggest that the lower mortality rates of Iowa farmers are a reflection of a life-style that includes vigorous exercise and little consumption of alcohol and tobacco.

Lipid and lipoprotein distributions in white children ages 6–19 yr. The lipid research clinics program prevalence study

Cross-sectional age- and sex-specific distributions of plasma lipids and lipoproteins are described for 1402 white children ages 6–19 yr. These children were part of a random sample examined at seven lipid research clinics (LRC) during the LRC Prevalence Study, which was established to determine the prevalence of hyperlipidemias and to describe the distribution of lipids and lipoproteins in diverse populations. These populations were not selected to be representative of the entire North American pediatric population. Nonetheless, the large numbers of children in the seven LRC populations and their socioeconomic and geographic diversity do permit analytical and comparative studies of physiological and sociodemographic variables in school-age children. This report of their lipid and lipoprotein levels is one in a series of such studies. Examination of the distribution of plasma lipids and lipoproteins showed that total cholesterol (TCH) and low-density lipoprotein cholesterol (LDL-c) were lower in males than females in most age groups studied. The difference in LDL-c is most marked in the younger age group (ages 6–9 yr) and accounts for most of the difference in TCH concentration at this age. During the adolescent period (ages 10–14 yr) a decline in high-density lipoprotein cholesterol (HDL-c) concentration occurs in the males, but not in the females. This decline continues throughout the postadolescent (ages 16–19 yr) period. The resulting difference in HDL-c mainly accounts for the higher TCH observed in the 16–19 yr-old females. Our study confirms the fall in TCH concentration at about adolescence described previously. However, it highlights the different mechanisms responsible in the two sexes. Whereas in the males the decline in TCH is mainly the result of reduction in the concentration of HDL-c, in the females it is due mainly to a gradual decline in LDL-c.

Lipoprotein-cholesterol distributions in selected North American populations: the lipid research clinics program prevalence study.

Total plasma lipid and lipoprotein-cholesterol distributions of 4756 white men and women between the ages of 20-59 are presented. Measurements were obtained during the visit-2 survey of the (LRC) Lipid Research Clinics Program Prevalence Study and correspond to a 15% random sample of 35748 white adults screened during the LRC visit-1 survey. Standardized examinations were carried out by 10 North American clinics using a common protocol on diverse target populations chosen to include a range of sociodemographic characteristics. Age-specific means medians and selected percentiles are given by sex with stratification on exogenous sex hormone use in women. Plasma lipid and lipoprotein concentrations in men and women vary with age. Differences in lipid and lipoprotein levels between the study populations are also present and manifest themselves as parallel trends of age-related changes in the 10 populations examined. Higher total cholesterol values in men as compared with women appear between the ages of 20-50 and higher LDL cholesterol between ages 20-55. VLDL cholesterol levels are similar in both sexes at ages 20 and 59 years but higher in men than in women in all intermediate age groups. HDL cholesterol is higher in women than in men throughout the age range under consideration. Women taking sex hormones have higher total cholesterol than women not on hormones between ages 20-50 and higher LDL cholesterol between 20-40. From the 3rd age decade onward HDL cholesterol levels are progressively higher in women taking hormones than in women who are not. Compared with women not taking exogenous sex hormones women taking hormones have higher total plasma triglyceride values at all ages from 20-59. VLDL cholesterol values are higher in women on hormones compared with nonusers of hormones younger than 55 years. (Authors modified)