Non–high-density lipoprotein cholesterol (non–HDL-C) contains all known and potential atherogenic lipid particles. Therefore, non–HDL-C level may be as good a potential predictor of risk for cardiovascular disease (CVD) as low-density lipoprotein cholesterol (LDL-C).
To determine whether non–HDL-C level could be useful in predicting CVD mortality and to compare the predictive value of non–HDL-C and LDL-C levels.
Data are from the Lipid Research Clinics Program Follow-up Study, a mortality study with baseline data gathered from 1972 through 1976, and mortality ascertained through 1995. A total of 2406 men and 2056 women aged 40 to 64 years at entry were observed for an average of 19 years, with CVD death as the main outcome measure.
A total of 234 CVD deaths in men and 113 CVD deaths in women occurred during follow-up. Levels of HDL-C and non–HDL-C at baseline were significant and strong predictors of CVD death in both sexes. In contrast, LDL-C level was a somewhat weaker predictor of CVD death in both. Differences of 0.78 mmol/L (30 mg/dL) in non–HDL-C and LDL-C levels corresponded to increases in CVD risk of 19% and 15%, respectively, in men. In women, differences of 0.78 mmol/L (30 mg/dL) in non–HDL-C and LDL-C levels corresponded to increases in CVD risk of 11% and 8%, respectively.
Non–HDL-C level is a somewhat better predictor of CVD mortality than LDL-C level. Screening for non–HDL-C level may be useful for CVD risk assessment.