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. 2014 Mar 13;3(2):e000519.
doi: 10.1161/JAHA.113.000519.

Coronary heart disease risks associated with high levels of HDL cholesterol

John T Wilkins  1 , Hongyan Ning, Neil J Stone, Michael H Criqui, Lihui Zhao, Philip Greenland, Donald M Lloyd-Jones
Affiliations

Coronary heart disease risks associated with high levels of HDL cholesterol

John T Wilkins et al. J Am Heart Assoc. .

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.

Keywords: CHD events; total mortality; very‐high HDL‐C.

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Figures

Figure 1.
Figure 1.
Log hazard ratios (95% CI) for CHD events by HDL‐C for men and women. CHD indicates coronary heart disease; HDL‐C, high‐density lipoprotein cholesterol.
See this image and copyright information in PMC

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