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Michael Miller, MD
The Johns Hopkins Hospital Baltimore, Md

JAMA. 1990;263(13):1768.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The National Cholesterol Education Program¹ defines hypercholesterolemia as a total cholesterol level of 6.2 mmol/L or greater and borderline hypercholesterolemia as a serum total cholesterol level between 5.2 and 6.2 mmol/L. Desirable cholesterol levels are below 5.2 mmol/L. In the study by Drs Vega and Grundy,² "normolipidemic" patients (most of whom had coronary disease) with reduced high-density lipoprotein cholesterol were given pharmacologic agents to determine if elevations in high-density lipoprotein cholesterol levels could be achieved.

This is an important issue, since low levels of high-density lipoprotein cholesterol are prevalent among patients with coronary artery disease even when cholesterol levels are below 5.2 mmol/L.³ However, it is not clear from the study how "normolipidemia" was defined. Exclusion criteria included plasma total cholesterol levels greater than 6.47 mmol/L; based on this criterion, patients with borderline to high cholesterol levels qualified. Indeed, the concentration of plasma . . . [Full Text PDF of this Article]

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