Purpose: To determine the the prevalence of isolated low high-density lipoprotein cholesterol and its response to hygienic therapy in coronary patients after major cardiac events.
Methods: Data before and after phase II cardiac rehabilitation and exercise training were assessed in 275 consecutive patients from two institutions. All patients had known coronary artery disease and underwent a 12-week program of aggressive hygienic therapy. The prevalence of isolated low high-density lipoprotein cholesterol in this cohort was determined and its response to vigorous nonpharmacologic therapy was assessed and compared with that of other coronary patients undergoing similar therapy.
Results: At baseline, 113 (41%) had low high-density lipoprotein cholesterol, including 70 (25%) with isolated low high-density lipoprotein cholesterol. In contrast, 147 (53%) had "high-risk" low-density lipoprotein-cholesterol > or = 130 mg/dL. In the subgroup with isolated low high-density lipoprotein cholesterol, improvements occurred in body mass index, metabolic equivalents, high-density lipoprotein cholesterol, and low-density lipoprotein/high-density lipoprotein cholesterol. Compared with 205 patients without isolated low high-density lipoprotein cholesterol, this subgroup had much greater improvements in high-density lipoprotein cholesterol (+17% versus +2%; P < .001) and low-density lipoprotein/high-density lipoprotein cholesterol (-11% versus -6%; P < .02), with similar improvements in most other major coronary artery disease risk factors.
Conclusion: These results suggest that isolated low high-density lipoprotein cholesterol is prevalent in patients with coronary artery disease and is sensitive to aggressive hygienic interventions.