The Relation of Hyperlipidemia with IHD in young and middle age in Tikrit city

Hyperlipidemia is a major risk factor of ischemic heart disease (IHD). Many studies have demonstrated a direct conelation between raised serum lipids levels and incidence of IHD and atherosclerosis in humans. One hindered lifty healthy control individuals (86 male and 64 lbmales)and (150) patients suffering from previous IHD (84 males and 66 flemales) were involved in this study. The blood samples from these groups were analyzed for serum total cholesterol, triglycelides, low-density lipoprotein, and high-density lipoprotein .All control individuals have a normal fasting blood glucose, normal resting electrocardiograph, blood pressure and serum lipids. The results revealed highest frequency of IHD in males (29.7 6%) and females (25.76%) among the age group (50-59) years. Also it showed that about (25%) of males and (24.24%) of f'emales who were suffering from IHD were below 40 years.


Introduction
Ischemic heart diseases (IHD) are a leading cause ol mo(ality and morbidity in industrial countries. and they are also emerging as a prominent health problem in developing countries []. IHD is characterized by widespread and severe atherosclerosis. It may manif'est itself as an acute and often fatal attack ol Myocardial inlarction ( M1.1. or as an angina pectoris, congestive hearl failure, or arrhythmia Itt t"t. The increase in incidence of atherosclerosis and subsequently coronary heart disease (CHD), Myocardial infarction (MI), Cerebrovasecular diseases and other diseases have focused the attention on the important role of nutrition and health in the world, especially in developed countries. The incidence ofthese diseases in developing countries has increased in the last (15) years as result of the enhancement of the economic situation, which suggests that environment and dietary habits may contribute to these diseases [3,4]The relationship between plasma lipid abnormalities and the risk for ischemic hearl disease (IHD) is now clearly established. In addition to quantitative abnormalities such as increased plasma low density lipoprotein cholesterol (LDl-Cholesterol) and decreased high-density lipoprotein cholesterol (HDl-Cholesterol) levels ,lipid qualitative abnormalities are likely to play an important role in the pathogenesis of atherosclerosis [5] .Hyperlipidemia (HL) is a common disease that leads to considerable morbidity and mortality. It is a major risk factor for the development of atherosclerosis [6].
Ischemic heaft disease can be considered as the major cause of death in the world in about (50) countries and mortality is higher than that caused by cancer, accident or communicable disease [8]. Prior to World War II, IHD was considered to be uncommon event in patients under (40) years of age [9].The present study is undeftaken to find out the rate of hyperlipidemia in ischemic heart disease and its relationship with young and middle age patients with IHD.

Material and Methods
Blood samples were taken from (150) healthy control individuals (

Results
The distributions of sex and age of patients and control group \ /ere given in  (Figure 1 (B)) means of serum triglyceride (TG) concentration both in the males and females are higher as compared to the reported normal r alues in literature [0.11.12]. The results of (TC) and (TG) are shown in the figure (1 A and B). It was observed that there were significantly dillerences in rnean levels of (TC) in IHD with hyperlipidemia in comparison with IHD at upper limit of lipids groups and also more than that in control groups (P<0.05), the same result detected in mean levels of (TG). In contrast the difTerence between control and IHD at upper limit of lipids groups were statistically insignificant .in the same figure the diflerence in mean levels of (TC) and (TG) between he age groups were statistically significant (P<0.05).
T'he values of serum HDl-cholesterol and LDLcholesterol were given in the figure (2 A and B). It was shown that the levels of IIDL-C and LDL-C in control groups increased with age until (60-69) years and then decline. In the same figure the difference in the mean values of HDL-C between control groups and IHD with hyperlipidemia, and between control and IHD at upper limit of lipids groups revealed statistically significant decrease (P<0.05). In contrast there were no statistically significant decrease in the values of HDL-C between IHD with hyperlipidemia groups and IHD at upper limit of lipids groups. The figure also showed that there were statistically significant increase in the levels ol LDL-C when comparing groups (control, IHD at upper limit of lipids and IHD with hyperlipidemia) (P<0.05). The levels of LDL-C statistically significant (P<0.05) in comparison between age groups.

Discussion
During past 5 decades a large number of studies have been performed conceming the effect of age and sex on IHD and its correlation with blood lipids and lipoproteins levels in several populations [10,11]. Interest in serum lipid concentrations in heath and disease have been greatly stimulated since a close correlation was found between the raised fasling serum lipid concentrations and the prevalence of IHD [12,13] This study we showed that the percentage of patients with IHD in young age groups increased which may indicate that the patients are more prone to risk factors at earlier age groups. The results of the present study revealed that the levels of (TC),(TG) and LDL-C were increased in patients suffering from previous sign of IHD. It also showed in the same figure that the level of HDL-C was lower in IHD groups in comparison to control groups .The results of the present study have also detected that the levels of serum lipids were significantly increase with age. Slightly higher 1eve1s of serum lipids in the males than females in early age were also found, in contrast they were higher in females than males in age groups more than 50 years. These results were in agreement with that report by Heiss et al.