Coronary heart disease (CHD) remains the leading cause of death and is a major cause of morbidity among men and women in the United States.<sup>3 American Heart Association 1998 Heart and Stroke Facts: Statistical Update Dallas: AHA (1998). 

Cliquez ici pour aller à la section Références</sup> The role of elevated concentrations of serum cholesterol and low-density lipoprotein (LDL) in the pathogenesis of atherosclerosis is well established. Evidence supporting the atherogenic effects of LDL include studies of diet-induced atherosclerosis in animals; clinical studies in humans with genetic disorders, such as familial hypercholesterolemia, that are associated with a high risk for premature atherosclerosis; and pathologic studies, demonstrating that cholesterol derived from LDL is present in atherosclerotic plaques. Epidemiologic studies have consistently shown higher rates of CHD in populations with higher mean concentrations of total and LDL cholesterol, and migration studies demonstrate increased rates of CHD in groups that have moved from a low-cholesterol to a high-cholesterol environment. Results from the Multiple Risk Factor Intervention Trial (MRFIT), in which CHD mortality was assessed in 356,222 men followed for more than 6 years, demonstrated a curvilinear relationship between increasing plasma concentrations of total cholesterol and risk for CHD. The risk increased slightly as total cholesterol values rose from 150 to 200 mg/dL but was approximately 2 and 4 fold higher when cholesterol values were increased to 250 and 300 mg/dL compared with values at 200 mg/dL.<sup>59 Stamler M., Wentworth D., Neaton J.D., for the MRFIT Research Group Is the relationship between serum cholesterol and the risk for premature death from coronary heart disease continuous or graded? Findings in 356,222 primary screenees of the multiple risk factor intervention trial (MRFIT) JAMA 1986 ;  256 : 2823-2828

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