RT Journal
A1 Ahmad Z, Garg A
T1 LAck of cardiovascular disease among old order amish with familial defective apolipoprotein b
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD June 13
VO 171
IS 11
SP 1039
OP 1040
DO 10.1001/archinternmed.2011.238
UL http://dx.doi.org/10.1001/archinternmed.2011.238
AB 
Surprisingly, a self-reported history of cardiovascular disease (CVD) was not different among individuals with RR, RQ, and QQ genotypes despite extremely low frequency of lipid-lowering medication use. Especially striking is the lack of increased prevalence of historical CVD in the stage 2 participants who were older, with a mean age of 57 to 59 years. We wonder if the study sample may be biased because some affected individuals harboring R3500Q variants may have developed CVD earlier in life and may have died suddenly prior to reaching their 40s (mean age in stage 1 participants). Was information about family history of premature CVD or sudden death collected? We would expect that individuals with heterozygous or homozygous R3500Q variant should report more cardiovascular events among their relatives than individuals not harboring the mutation. Alternatively, is it possible that R3500Q mutation in Old Order Amish despite increasing LDL-C levels and coronary artery calcium scores on electron beam computed tomography does not increase cardiovascular events?