Serum lipoproteins and susceptibility of men of Indian descent to coronary heart disease. The St James Survey, Trinidad.

Prevalence of coronary heart disease (CHD) and fasting serum lipoprotein concentrations in ethnic groups in Port of Spain, Trinidad, were compared. In a total community survey of 1416 men aged 35-69 years, angina pectoris, a history of possible myocardial infarction, and major Q waves on the electrocardiogram were significantly more common in men of Indian descent than in other ethnic groups (relative risk about 3/1). Indians had significantly lower high-density-lipoprotein-cholesterol (HDLCh) concentrations and significantly higher low-density-lipoprotein-cholesterol (LDLCh) concentrations than other groups. After allowance for age and ethnic group, men with major Q waves or a history of possible myocardial infarction had a significantly greater ratio of LDLCh/HDLCh that men without either. Comparison of surveys in the Caribbean suggests that in this region CHD is prevalent only in communities in which a sizeable proportion of men have an LDHCh/HDLCh ratio greater than 6 and an LDLCh concentration above 5 mmol/l.