Serum Lipid Levels and the Severity of Coronary and Cerebral Atherosclerosis in Adequately Nourished Men, 60 to 69 Years of Age

A LMOST 10 years have passed since we initiated a long-term project to determine the relationship, if any, between the levels of the serum lipids, estimated serially during life in ambulatory patients who were permanently confined to hospital, and the severity of atherosclerosis found at death and autopsy in the same patients. Several interim reports on our findings have been published,'-each of them failing to show any impressive relationships between the serum lipid levels and the severity of disease. However, none of these interim reports satisfied completely the requirements laid down originally by us for a proper evaluation of the problem. In our first report, for example, because such a small number of fatalities was available at the time, no allowance could be made for the factor of age in the progression of the disease.' Later reports took the age factor and other variables into consideration. The number of fatalities that have been autopsied is now sufficiently large that it is feasible to exclude from the series all individuals who died from diseases that involved wasting. This correction has been made because many research workers on this continent believe that the human atherosclerotic process is reversible to a degree, that in emaciated individuals the arterial lipid accumulations may be resorbed in exactly the same fashion as are the fat depots in other parts of the body. The present report, which we expect will be the last one in this particular series, gives a comparison of the antemortem levels of serum cholesterol, cholesterol-phospholipid ra-