Castelli W P
Department of Preventive Medicine and Epidemiology, Harvard Medical School.
Am J Obstet Gynecol. 1988 Jun;158(6 Pt 2):1553-60, 1566-7. doi: 10.1016/0002-9378(88)90189-5.
Cardiovascular disease is the leading cause of death in American women. Atherosclerotic diseases, primarily myocardial infarction and stroke, are important causes of morbidity and mortality among women. Contrary to popular belief, the actual number of myocardial infarctions in men and women is similar, although women develop cardiovascular disease an average of 10 years later than do men. Total serum cholesterol level is a major indicator of risk of coronary heart disease; for every 1% increase in the total serum cholesterol level, a 2% increase in incidence of coronary heart disease is found. A high level of low-density lipoproteins is an independent risk factor for coronary heart disease in both mean and women, but high triglyceride level is an independent risk factor only in women. Conversely, the higher the level of high-density lipoprotein, the lower the risk of coronary heart disease. To reduce the risk of coronary heart disease, target levels of total serum cholesterol must be lowered from 300 to 200 mg/dl. If the total cholesterol/high-density lipoprotein ratio is greater than or equal to 4.5 of if the low-density lipoprotein concentration is greater than 150 mg/dl, the patient is at high risk for coronary heart disease. Clinical trials that use diet or drugs to lower serum cholesterol levels have consistently shown a 2% reduction in the incidence of coronary heart disease for every 1% reduction in total serum cholesterol level.
心血管疾病是美国女性的首要死因。动脉粥样硬化疾病，主要是心肌梗死和中风，是女性发病和死亡的重要原因。与普遍看法相反，男性和女性心肌梗死的实际发生数量相似，尽管女性患心血管疾病的平均时间比男性晚10年。血清总胆固醇水平是冠心病风险的主要指标；血清总胆固醇水平每升高1%，冠心病发病率就会升高2%。高水平的低密度脂蛋白是男性和女性冠心病的独立危险因素，但高甘油三酯水平仅是女性的独立危险因素。相反，高密度脂蛋白水平越高，冠心病风险越低。为降低冠心病风险，血清总胆固醇的目标水平必须从300毫克/分升降至200毫克/分升。如果总胆固醇/高密度脂蛋白比值大于或等于4.5，或者低密度脂蛋白浓度大于150毫克/分升，患者患冠心病的风险就很高。使用饮食或药物降低血清胆固醇水平的临床试验一直表明，血清总胆固醇水平每降低1%，冠心病发病率就会降低2%。
