The Prospective Cardiovascular Münster Study: prevalence and prognostic significance of hyperlipidemia in men with systemic hypertension

Abstract

The ongoing Prospective Cardiovascular Münster (PROCAM) trial was initiated to identify risk factors for coronary artery disease (CAD). By comparing patients' long-term cardiac status (clinical signs of atherosclerosis, myocardial infarction, stroke or death due to atherosclerotic disease) with results from entrance questionnaires, physical examinations, blood pressure measurements, electrocardiograms at rest and blood analyses, the characteristics and strategies for identifying people in the general population who are at risk for developing CAD were to be determined. From PROCAM trial data, 3 predictive criteria for identifying such people have been determined: They are a total cholesterol/high density lipoprotein (HDL) cholesterol ratio of 6.5 was determined to be the threshold for CAD risk. Combined analysis of lipid parameters identified high-risk patients as those with cholesterol values of greater than or equal to 300 mg/dl, and low-risk patients as those with cholesterol and triglyceride values less than 200 mg/dl. The remaining subjects are classified according to their HDL cholesterol values. If the HDL cholesterol value is less than 35 mg/dl, the subject is considered to be at high risk, if HDL cholesterol is greater than or equal to 35 mg/dl the patient is considered to be at average risk. The upper 20% of risk was computed by means of a multiple logistic function based on statistics for age, total cholesterol and HDL cholesterol levels, systolic blood pressure, angina pectoris, diabetes mellitus, cigarette smoking and family history of myocardial infarction. A further analysis was the risk incurred by hypertension. Hypertension was observed in 16.5% of men and 13.9% of women.(ABSTRACT TRUNCATED AT 250 WORDS)