Coronary heart disease risks associated with high levels of HDL cholesterol.

Pubmed ID: 24627418

Pubmed Central ID: PMC4187512

Journal: Journal of the American Heart Association

Publication Date: March 13, 2014

Affiliation: Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL.

MeSH Terms: Humans, Male, Female, Aged, Risk Factors, United States, Middle Aged, Coronary Disease, Risk Assessment, Proportional Hazards Models, Multivariate Analysis, Prognosis, Time Factors, Cholesterol, HDL, Linear Models, Up-Regulation, Biomarkers

Grants: AG-023629, AG-027058, AG-15928, AG-20098, HL080295, N01 HC-15103, N01 HC-55222, N01-HC-35129, N01-HC-45133, N01-HC-75150, N01-HC-85079, N01-HC-85086, N01-HC-85239, HHSN268201200036C, R01 HL080295, U01 HL080295, R21 HL085375, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, HHSN268201100046C, HHSN271201100004C, HHSN268201100001I, HHSN268201100002I, HHSN268201100004I

Authors: Lloyd-Jones DM, Ning H, Criqui MH, Greenland P, Wilkins JT, Stone NJ, Zhao L

Cite As: Wilkins JT, Ning H, Stone NJ, Criqui MH, Zhao L, Greenland P, Lloyd-Jones DM. Coronary heart disease risks associated with high levels of HDL cholesterol. J Am Heart Assoc 2014 Mar 13;3(2):e000519.

Studies:

Abstract

BACKGROUND: The association between high-density lipoprotein cholesterol (HDL-C) and coronary heart disease (CHD) events is not well described in individuals with very high levels of HDL-C (>80 mg/dL). METHODS AND RESULTS: Using pooled data from 6 community-based cohorts we examined CHD and total mortality risks across a broad range of HDL-C, including values in excess of 80 mg/dL. We used Cox proportional hazards models with penalized splines to assess multivariable, adjusted, sex-stratified associations of HDL-C with the hazard for CHD events and total mortality, using HDL-C 45 mg/dL and 55 mg/dL as the referent in men and women, respectively. Analyses included 11 515 men and 12 925 women yielding 307 245 person-years of follow-up. In men, the association between HDL-C and CHD events was inverse and linear across most HDL-C values; however at HDL-C values >90 mg/dL there was a plateau effect in the pattern of association. In women, the association between HDL-C and CHD events was inverse and linear across lower values of HDL-C, however at HDL-C values >75 mg/dL there were no further reductions in the hazard ratio point estimates for CHD. In unadjusted models there were increased total mortality risks in men with very high HDL-C, however mortality risks observed in participants with very high HDL-C were attenuated after adjustment for traditional risk factors. CONCLUSIONS: We did not observe further reductions in CHD risk with HDL-C values higher than 90 mg/dL in men and 75 mg/dL in women.