Plasma Levels of Lipoproteins and Apolipoproteins in Octo- and Nonagenarians

A great deal of attention has been paid in recent years to high-density lipoproteins (HDL) and to their inverse relationship with the occurrence of ischemic heart disease (IHD). This attention to HDL is not new, as pioneer studies have already emphasized its value as a predictor of “de novo” cases of IHD [1], but it is only recently that a revival of interest in HDL has started, originating from both epidemiological and clinical studies. The seminal paper was by Miller and Miller [2], who stressed the inverse relationship existing between HDL and IHD. At about the same time other papers were published which referred to the existence of families whose members appeared to be protected from IHD by high levels of HDL cholesterol (HDL-C) [3,4,5] and/or of apolipoprotein A (apo A). Furthermore, Glueck et al. [6] proposed that high levels of HDL-C or low levels of low-density lipoprotein cholesterol (LDL-C), or a combination of the two parameters, constitute the features of a “longevity syndrome.” However, data obtained in two subsequent studies [7, 8] do not agree with the proposed biochemical pattern of longevity, although in neither study was the prevalence of hyper-α-lipoproteinemia recorded nor was it ascertained whether any relationship between the mortality rates and the levels of HDL-C existed [8].