Racial differences of lipoprotein subclass distributions in postmenopausal women.

BACKGROUND We assessed racial differences in lipoprotein particle size, a marker of atherosclerosis risk, among women with coronary disease. METHODS We studied 378 women (33% non-White, predominantly African American) at the baseline visit of the Women's Angiographic Vitamin and Estrogen Trial (WAVE), a multicenter trial of hormone replacement and antioxidant vitamin therapy in postmenopausal women with established coronary artery disease. Average particle sizes for high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein were measured by nuclear magnetic resonance in these women, and angiography was performed at baseline and followup. RESULTS Adjusted for age, race, diabetes, smoking, blood pressure, and use of lipid-lowering and antihypertensive medications, non-White women had larger LDL particle size (difference .2 nm, 95% CI .1-.3 nm) and HDL particle size (difference.2 nm, 95% CI .1-.2 nm). Neither angiographic disease progression nor survival without myocardial infarction (median follow-up time of 2.8 years) was associated with lipoprotein particle size or race. CONCLUSIONS Non-White women have a less atherogenic profile of lipoprotein particle sizes than do White women. However, this difference did not affect event-free survival or angiographic progression of coronary atherosclerosis.