Because lipid abnormalities and their relationships with cardiovascular risk are not well characterized in the Asian population, the INTERHEART study focused specifically on this issue. In this study, 65 centres in Asia recruited 5,731 cases of acute myocardial infarction (MI) and 6,450 controls. LDL cholesterol concentrations were lower in Asians compared to non-Asians, in both cases and controls. Moreover, a greater proportion of Asian individuals had LDL cholesterol ≤2.59 mmol/l (100 mg/dl) compared to non-Asians. However, HDL cholesterol concentrations were also lower in Asian individuals, especially in South Asians. Despite these differences, the risk of acute MI associated with elevated LDL cholesterol or low HDL cholesterol concentrations was similar between Asians and non-Asians. Apolipoprotein AI/apolipoprotein B ratio was the strongest variable associated with MI. These results suggest that lipid targets should take into account ethnicity.
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