STUDY OBJECTIVE--The aim of the study was to determine whether the inverse association between high density lipoprotein cholesterol concentration and risk of coronary heart disease described in people of European stock was also present in other racial groups. DESIGN--The study was a prospective population survey. Cardiovascular risk factors were examined, including fasting serum lipid estimation (obtained at recruitment). SETTING--This was a community based study within a defined survey area in Trinidad. PARTICIPANTS--All men aged between 35 and 69 years within the survey area were identified and followed between 1977 and 1986. Analysis was confined to those of African, Asian Indian, and mixed descent who were free of coronary heart disease at entry (n = 960, 69% of age eligible men in the survey population). MEASUREMENTS AND MAIN RESULTS--64 men developed coronary heart disease during the study period. A strong inverse curvilinear relation was found between high density lipoprotein cholesterol and coronary heart disease incidence (p less than 0.005), independent of age or other relevant characteristics including low density lipoprotein cholesterol. CONCLUSIONS--A low serum concentration of high density lipoprotein cholesterol is a risk factor for coronary heart disease in non-whites as well as in whites.
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