Lipid Research Clinics (LRC) Program Prevalence Study

Background:

Drs. Fredericksen and Levy at the National Heart and Lung Institute in the 1970s initiated a massive effort to standardize methods and systematically study the distribution of lipids and lipoproteins and their association with diet and coronary heart disease in the U.S. and abroad. The aims were to provide a firm foundation for study of the diet-lipid issue and an evidence base for the preventive interventions they envisioned, including the LRC Coronary Primary Prevention Trial.

Method and Populations:

The LRC Prevalence Study shared large population bases in 10 North American and two Soviet Union populations, and in one Israeli population, for whom data were collected in two screening surveys. Sub-samples of the prevalence screenees were enrolled in family studies among first-degree relatives and spouses and in a prospective study of mortality by age, gender, ethnic, and socioeconomic groupings.

60,000 subjects aged less than 5 years to greater than 80 years, were surveyed from a broad range of geographic, ethnic, age, and gender groups, with a 74 percent response, 90 percent of whom reported fasting. Autoanalyzer lipid results were standardized and risk characteristics measured, including eating and exercise behaviors, diet, lifestyles, and familial traits. Supportive facilities were developed for coordination, lipid analysis, and nutrition coding along with mortality and morbidity data.

Results:

Age rise in lipid levels and geographic mean differences were reported; men had higher levels than women, and women on sex hormones had higher levels. Follow-up of a cohort of 8,825 more than age 30 years showed a strong inverse relationship of HDL cholesterol and CVD mortality, greater in women than men, and no relation to non-CVD mortality.

Conclusions:

This major cross-section and cohort study provided distribution of lipoprotein fractions for North America and confirmed the predictive relations of lipoproteins found in other studies, elaborating the independent association of HDL with risk of CVD. (HB)