Fifty-three year follow-up of coronary heart disease versus HDL2 and other lipoproteins in Gofman's Livermore Cohort

To assess the relationships of lipoprotein mass concentrations to all-cause and coronary heart disease (CHD) mortality, we analyzed the prospective 53-year follow-up of 1,905 men measured for lipoprotein mass concentrations by analytic ultracentrifugation between 1954 and 1957. Cause of death was determined from medical records and death certificates before 1979 and from National Death Index death diagnoses thereafter. Of the 1,329 men (69.8%) who died through 2008, CHD was listed as a contributing cause of death for 409 men, including 113 deaths from premature CHD (age ≤ 65 years). When adjusted for age, the risk associated with the lowest HDL2 quartile increased 22% for all-cause (P = 0.001), 63% for total CHD (P < 10(-5)), and 117% for premature CHD mortality (P = 0.0001). When adjusted for standard risk factors (age, total cholesterol, blood pressure, BMI, smoking) and the lowest HDL3 quartile, the corresponding risk increases were 14% (P = 0.05), 38% (P = 0.004), and 62% (P = 0.02), respectively. Men with HDL3 ≤ 25(th) percentile had 28% greater total CHD risk (P = 0.03) and 71% greater premature CHD risk (P = 0.01). Higher LDL-mass concentrations increased total CHD risk by 3.8% (P < 10(-9)) and premature CHD risk by 6.1% (P < 10(-7)) per 10 mg/dl increase in concentration. Thus, low HDL2 is associated with increased CHD risk.