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Very high HDL-C may not reduce CV risk or protect against high LDL-C

10 Jan 2018

Although higher levels of HDL-cholesterol (HDL-C) are associated with reduced cardiovascular disease (CVD) risk, the relationship is not linear and after an intermediate range of 50–70 mg/dL, very high HDL-C is not always associated with lower CV risk. [Pagidipati P, AHA 2017, abstract 779]

In a study of data from 22,569 adults without prior CVD followed for a median of 19.5 years, 6,539 died, 31 percent of which were CV deaths. Comparing to a reference point of 50 mg/dL and adjusting for factors including age, race and systolic blood pressure, lower HDL-C was associated with higher CVD composite events (CV death, MI, angina or stroke), but higher HDL-C was not, suggesting a U-shaped relationship between HDL-C and CV risk.

“Higher HDL-C is not always better,” said lead researcher Dr Neha Pagidipati of the Duke Clinical Research Institute in Durham, North Carolina, US. “This may help us understand why many cholesteryl ester transfer protein [CETP] inhibitor trials and niacin trials didn’t necessarily result in lower CVD with higher HDL-C.”

“The benefit of high HDL-C was also not fully balanced by the risk of high LDL-C, especially in women,” Pagidipati added. 

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Most Read Articles
18 Apr 2018
Higher intake levels of coffee appear to be associated with reduced risk of developing chronic kidney disease, according to data from the Atherosclerosis Risk in Communities Study.
Jairia Dela Cruz, 6 days ago
Infants delivered via caesarean section may be at increased risk of developing acute lymphoblastic leukaemia, according to a US study. Altered microbiota colonization is a possible explanation for this risk, although clear biological mechanisms have yet to be established.
6 days ago
Treatment with danegaptide does not improve myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention, according to the results of a phase II study.
Pearl Toh, 3 days ago
Tai Chi may be equivalent to pulmonary rehabilitation (PR) in improving health status of patients with chronic obstructive pulmonary disease (COPD), a recent study shows.