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© 1994 Oxford University Press

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Raised Lipoprotein(a) in Hypercholesterolaemic Black Students Compared to Age-Matched Whites in North and Souch Carolina

SIEGFRIED HEYDEN*, ARNOLD VON ECKARDSTEIN{dagger}, HELMUT SCHULTE{dagger}, KENNETH SCHNEIDER*; and GERD ASSMANN{dagger}

* Department of Community and Family Medicine, Duke University Medical Center Box 2914, Durham, NC 27710 USA
{dagger} Institute of Atherosclerosis Research, University of Münster Germany

BACKGROUND: North and South Carolina are the states with the highest coronary death rates and also belong to the ‘Stroke Belt’ of the US. From a Reflotron cholesterol screening in North and South Carolina schools, students with cholesterol levels>4.66 mmol/1 (>180 mg/dl) were tested for high density lipoprotein (HDL), low density lipoprotein (LDL) and lipoprotein(a)(Lp(a)).

METHODS: The 923 students aged 12–19 with mild hypercholesterolaemia represented one-third of the high school population, of whom 30% are black. Of the hypercholesterolaemic white students, 96% took the additional tests, of the hypercholesterolaemic black students, 88% responded. Lp(a) levels were determined by eledroimmunodiffusion.

RESULTS: Most important was a three-fold elevation of the geometric mean of Lp(a) values among blacks compared to whites: white males 9, white females 10, black males 25, black females 26 mg/dl, respectively, independent of age and sex. Relationships between Lp(a) and four other lipids/lipoproteins were examined and proved non-significant except for total cholesterol and LDL in black males and white females. While 70% of the white students displayed Lp(a) levels<20 mg/dl, 65–70% of the black students showed Lp(a) levels>20 mg/dl.

CONCLUSIONS: Early identification of high Lp(a) levels may be of importance for two groups, (1) black females who have a 20% higher coronary heart disease mortality rate than white females in spite of significantly higher HDL levels; and (2) for black males and black females who have a prevalence of cerebrovascular disease twice as high as in whites.

Received 1 October 1993


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