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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
Jairia Dela Cruz, 05 Oct 2020
Drinking more than two cups of coffee per day may just be the intervention that prevents hundreds of thousands of liver disease‐related deaths globally, a study reports.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
Roshini Claire Anthony, 12 Oct 2020

Insulin icodec, an in-development basal insulin analogue administered once weekly, was as effective as once-daily insulin glargine in patients with type 2 diabetes (T2D) insufficiently controlled with metformin with or without a DPP-4* inhibitor, according to a phase II trial presented at EASD 2020.

Stephen Padilla, Yesterday
Use of systemic corticosteroids does not reduce in-hospital mortality for patients with severe or critical coronavirus disease (COVID-19), which is in stark contrast to that observed in the RECOVERY clinical trial, according to a study in Wuhan, China.