The genetic contribution to coronary heart disease through lipoprotein concentrations.

Many factors both genetic and environmental contribute to the liability to coronary heart disease and one of the genetically determined risk factors is the concentration of lipoproteins in the blood. The evidence so far is that serum cholesterol level is polygenically determined, but that in a minority of the population it is determined by a single mutant gene of large effect. There is evidence that the risk of coronary death for affected individuals is very high and that the condition warrants a maximum effort at identification and treatment. For the remainder of the population whose hyperlipidaemia is polygenically determined, the liability to coronary heart disease might be substantially reduced by simple and appropriate environmental measures aimed at reducing the total liability. The measures if correctly applied should effectively improve the population risks of early coronary death.