Black-white differences in plasma levels of apolipoproteins: the Evans County Heart Study.

Evans County black males had lower ischemic heart disease (IHD) prevalence, incidence, and mortality than white males. High-density lipoprotein (HDL) cholesterol was lower in IHD cases than in subjects without IHD. HDL cholesterol and apolipoprotein A-I (Apo A-I) were higher and low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, and Apo C-II were lower in black than white males. Of the black-white male HDL cholesterol difference, 22% was statistically explained by Apo A-I. Controlling for Apo C-II reduced the black-white differences in total cholesterol 87%, LDL cholesterol 44%, VLDL cholesterol 83%, and total triglyceride 83%. There were negative associations between Apo A-I and age, Quetelet index, and cigarettes smoked; the association between Apo A-I and alcohol was positive. Only body mass index and race were strong correlates of Apo C-II. The ratios of Apo A-I to Apo A-II and of HDL cholesterol to Apo A-II were higher in black than white males with adjustment for age, body mass, and cigarette and alcohol consumption. Thus black-white differences in total lipids, lipoprotein lipids, and lipoprotein apoproteins were observed, indicating a relatively antiatherogenic profile in black males only partially explained by known correlates.