Youthful hypercholesteremia: its associated characteristics and role in premature myocardial infarction.

Hypercholesteremic medical students were different from their normocholesteremic classmates in a variety of ways. When students are grouped by cholesterol level in medical school, gradients across the means of biological, physiological, physical, and psychological characteristics are found. The hypercholesteremic students were older, shorter, and heavier, with younger mothers, less depression, less anxiety and less overall nervous tension under stress. Compared with their normocholesteremic classmates, youthful hypercholesteremics were more than 30 times as susceptible to episodes of acute myocardial infarction occurring 13 to 21 years after the high cholesterol levels were measured. Ten male medical students who subsequently sustained a myocardial infarction, most of whom were known to have had hypercholesteremia in youth, were significantly different at the outset from their 103 hypercholesteremic classmates who have not had such an episode. On the average, the precoronary individuals in medical school were shorter in stature, were older, had more overall nervous tension under stress, were more tired on awakening and had lower academic standing. The combination of hypercholesteremia and a personality profile denoting sensitivity and vulnerability to stress best characterizes this group of ten subjects who sustained a myocardial infarction at an early age. These findings suggest that it may be possible to differentiate young hypercholesteremics who are highly susceptible to myocardial infarction from their hypercholesteremic peers with relatively low susceptibility on the basis of personality profile.