A 72-year-old retired tailor, an Italian immigrant, living in Los Angeles, Calif, consulted his family physician after persistent urging by his wife following the recent death of a relative with an acute myocardial infarction. The tailor was overweight and a habitual cigar smoker, but felt well. The history, physical examination, and electrocardiogram were normal, however a routine blood lipid analysis revealed an unusually low high-density lipoprotein (HDL) level of 20 mg/dL (0.52 mmol/L). The serum low-density lipoprotein (LDL) level was 100 mg/dL (2.59 mmol/L) and the triglyceride level was 180 mg/dL (2.03 mmol/L). Because the HDL level was unusually low and at a level the family physician had not previously observed, he consulted with the Atherosclerosis Research Center at the Cedar Sinai Medical Center in Los Angeles, California, where extensive lipid research was being carried out. On their recommendation,...

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