Prevalence of hypercholesterolemia.
Since the early 1960s. the average cholesterol level among the US population has slightly decreased. But even with this reduction, 50% of American adults have cholesterol levels> 200 mg / dl, and 17% have cholesterol levels> 240 mg / dl. Low levels of HDL cholesterol and high levels of TG have a tendency to coincide and are often the result of metabolic changes leading to high levels of LDL cholesterol. Low levels of HDL cholesterol and high concentrations of TG can be observed separately or in combination with high LDL cholesterol.
Associated risk. Some cholesterol parameters have a causal relationship with an increased risk of CHD. An increase in serum LDL cholesterol by 1 mg / dL is associated with an increase in the risk of CHD by 2-3%, and at a young age, an elevated LDL cholesterol content may be associated with an even greater increase in risk. HDL has become an important independent predictor of KBS, a decrease in cholesterol cholesterol by 1 mg / dL leads to an increase in the risk of KBS by 3-4%. The ratio of total cholesterol or LDL cholesterol to cholesterol cholesterol predicts the risk of CHD better than LDL cholesterol.
Reducing this ratio by 1 unit (which can easily be achieved by prescribing statins) reduces the risk of myocardial infarction by 50%. The ratio of total cholesterol to cholesterol may be better than the ratio of apo A to apo B. The level of cholesterol also predicts risk well, since Non-HDL cholesterol correlates well with apo B, therefore costly definition of apo B is not necessary.
Inaccuracies in the determination of triglycerides (TG), intraindividual fluctuations, dependence on diet, and complex interactions between TG and other lipid parameters may disguise the contribution of TG to the development of CHD. However, the fasting TG level correlates with the risk of CHD, especially when the content of cholesterol cholesterol is taken into account. This interdependence suggests that some TG-rich lipoproteins are atherogenic. Some studies have suggested that elevated TG concentrations are an independent predictor of KBS. The clinical significance of TG, not assessed by fasting, remains unclear.