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The distribution of risk factors and the prevalence of coronary heart disease (CHD) were studied in 850 first- and second-degree relatives of 98 healthy index cases selected from 3666 school children surveyed for lipid levels in Rochester, Minnesota. Three groups of families were based on an index child's total plasma cholesterol level: 18 families with a child in less than the fifth percentile (low-cholesterol group), 47 with a child in the fifth to ninety-fifth percentiles (middle-cholesterol group) and 33 with a child in greater than the ninety-fifth percentile (high-cholesterol group). The children's cholesterol levels clustered with those of their relatives; mortality due to CHD before age 65 was increased by 2.5 times in grandfathers of index cases in the high-cholesterol group compared with those of the middle-cholesterol group (p less than 0.016). The prevalence of CHD in all the grandfathers was associated with an index child's total cholesterol, more strongly associated with an index child's low-density lipoprotein cholesterol level and most strongly associated with an index child's high-density lipoprotein cholesterol level as a fraction of total cholesterol. This study establishes that childhood lipid and lipoprotein levels from a single cross-sectional survey identify families at elevated risk for CHD.

Cholesterol and triglyceride levels in whole sera and in the major lipoprotein fractions are presented for 2,421 children and youths in Rochester, Minnesota, ranging in age from 6 to 18 years. This cross-sectional study revealed subtle changes associated with puberty and the occurrence of certain additional sex-specific changes related to age. Hyperlipoproteinemia was detected in 101 youngsters; those cases exemplified types IIa (61 cases), IIb (5 cases), III (5 cases), and IV (30 cases). One case of type V hyperlipoproteinemia was observed in a second and comparable population sample of 1,245 young persons.