Cholesterol Measurements May Be Made Easier

TUESDAY Nov. 10, 2009 -- Methods to gauge blood cholesterol to determine vascular disease risk can be simplified, researchers in England say.

Their method measures levels of either total or high-density lipoprotein (HDL, or "good" cholesterol) in the blood or apolipoproteins (proteins that help transport cholesterol), without the need to have patients fast and without regard to another form of blood fat called triglycerides.

"Expert opinion is divided" on which combination of measurements is ideal in gauging cardiovascular risk, explained John Danesh, of the Emerging Risk Factors Collaboration Coordinating Centre at the University of Cambridge, and colleagues.

In order to examine the association between major blood fats and apolipoproteins and coronary heart disease and ischemic stroke, the researchers analyzed data on more than 300,000 people without initial vascular disease who took part in 68 long-term studies.

During the follow-up periods of the studies, there were almost 8,900 nonfatal heart attacks, more than 3,900 coronary heart disease deaths, over 2,500 ischemic strokes, 513 hemorrhagic strokes and more than 2,500 unclassified strokes, the study authors noted.

The analysis of the data yielded a number of findings.

First of all, risk tied to blood levels of non-HDL-C and HDL-C were nearly identical to those seen with the two apolipoproteins (B and AI), the team found. "This finding suggests that current discussions about whether to measure cholesterol levels or apolipoproteins in vascular risk assessment should hinge more on practical considerations (e.g., cost, availability, and standardization of assays)," Danesh and colleagues wrote.

Secondly, risk assessments "were at least as strong in participants who did not fast as in those who fasted [before testing]," the team added, and risk was similar with non-HDL cholesterol as with directly measured LDL ("bad") cholesterol.

Finally, measuring for triglyceride blood fats "provides no additional information about vascular risk given knowledge of HDL-C and total cholesterol levels, although there may be separate reasons to measure triglyceride concentration (e.g., prevention of pancreatitis)," according to the report in the Nov. 11 issue of the Journal of the American Medical Association.

"The current analysis of more than 300,000 people has demonstrated that [blood fat] assessment in vascular disease can be simplified by measurement of either cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride," the researchers concluded.

More information

The U.S. National Heart, Lung, and Blood Institute has more about heart and vascular diseases.

Posted: November 2009


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