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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1996;16:339-349.)
© 1996 American Heart Association, Inc.

Articles

Poland and United States Collaborative Study on Cardiovascular Epidemiology

A Comparison of HDL Cholesterol and Its Subfractions in PopulationsCovered by the United States Atherosclerosis Risk in Communities Study and thePol-MONICA Project

Grayna Broda; Clarence E. Davis; Andrzej Pajak; O. Dale Williams; Stefan L. Rywik; Ewa Baczyska; Aaron R. Folsom; Moyses Szklo

From the Department of CVD Epidemiology and Prevention (G.B., S.L.R.), Stefan Cardinal Wyszyski National Institute of Cardiology, Warsaw, Poland; the School of Public Health (C.E.D.), University of North Carolina, Chapel Hill; the Unit of Clinical Epidemiology (A.P., E.B.), School of Public Health, Collegium Medicum, Jagiellonian University, Kraków, Poland; the School of Public Health (O.D.W.), University of Alabama, Birmingham; the School of Public Health (A.R.F.), University of Minnesota, Minneapolis; and the School of Public Health (M.S.), Johns Hopkins University, Baltimore, Md.

Correspondence to Sandra Irving, Collaborative Studies Coordinating Center, Suite 203, 137 E Franklin St, Chapel Hill, NC 27514. E-mail uccshi.cscc@mhs.unc.edu.

Abstract HDL cholesterol (HDL-C) levels are inversely related to coronary heart disease (CHD) risk, and HDL-C distributions vary among countries. Poland is one of the few developed countries in which CHD rates are increasing at the same time that US rates have been falling, but whether these differences are explained by differences in risk factors such as HDL-C has not been determined. To examine this possibility, levels of HDL-C and its subfractions were compared in US and Polish urban and rural men and women aged 45 to 64 years. Age-adjusted HDL-C means were 0.20 mmol/L higher in urban Polish men and 0.37 mmol/L higher in rural Polish men than in their US counterparts (P<.0001); means in urban Polish women were 0.06 mmol/L higher (P<.05) and in rural Polish women 0.09 mmol/L higher (P<.001) than in their US counterparts. Adjustment for age, education, alcohol intake, smoking, BMI, heart rate, and menopause status (in women) had little effect on differences. Means of HDL₂ and HDL₃ levels showed similar between-country differences, although differences were minimal for HDL₂ in urban men and women, and HDL₃ means did not differ between rural women. BMI was inversely related to HDL-C and both subfractions in all gender-country-site strata (P<.001), and alcohol was directly related to HDL-C (P<.001) in all strata except Polish women. Cigarette smoking was negatively related to HDL-C and both subfractions in all US samples except HDL₂ in urban men, whereas in Polish samples, significant associations were found only in urban women for HDL-C and in rural and urban women for HDL₃. Age, heart rate, and education showed inconsistent or no association with HDL-C and its subfractions in either country. This profile of HDL-C and its subfractions in Polish samples contrasts sharply with the opposite trend in CHD mortality rates, which suggests either that other risk factors may account for the trends or that the relationship between HDL-C and CHD may differ between the two countries.

Key Words: cardiovascular disease • HDL cholesterol • Poland • United States

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