Serum lipids and incidence of coronary heart disease: Findings from the systolic hypertension in the elderly program (SHEP)

Philip H. Frost*, Barry R. Davis, Alfredo J. Burlando, J. David Curb, Gordon P. Guthrie, Jonathan L. Isaacsohn, Sylvia Wassertheil-Smoller, Alan C. Wilson, Jeremiah Stamler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

142 Scopus citations


Background: The association of serum lipids with coronary heart disease has been studied extensively in middle-aged men and, to a lesser extent, in similar women. Less well defined are lipid variables predictive of CHD in individuals of age ≤60 years. Methods and Results: The Systolic Hypertension in the Elderly Program recruited 4736 persons (mean age, 72 years; 14% were black; and 43% were men). Mean systolic and diastolic blood pressures were 170 and 77 mm Hg, respectively. Baseline mean total cholesterol was 6.11 mmol/L (236 mg/dL); HDL cholesterol, 1.39 mmol/L (54 mg/dL); and non-HDL cholesterol, 4.72 mmol/L (182 mg/dL). Triglyceride levels were 1.62 mmol/L (144 mg/dL) for fasting participants and 1.78 mmol/L for the total group. LDL cholesterol, estimated in tasting samples with triglycerides of <4.52 mmol/L, averaged 3.98 mmol/L (154 mg/dL). Mean follow-up was 4.5 years. In multivariate Cox regression analyses, baseline total, non HDL, and LDL cholesterol levels and the ratios of total, non-HDL, and LDL to HDL cholesterol were significantly related to CHD incidence. HDL cholesterol and triglycerides were not significant in these analyses. In fasting participants with triglyceride levels of <4.52 mmol/L, a 1.03 mmol/L (40 mg/dL) higher baseline total, non-HDL, or LDL cholesterol was associated with a 30% to 35% higher CHD event rate. Conclusions: The results of this study support the concept that serum lipids are CHD risk factors in older Americans.

Original languageEnglish (US)
Pages (from-to)2381-2388
Number of pages8
Issue number10
StatePublished - 1996


  • cholesterol
  • coronary disease
  • lipids
  • lipoproteins
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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