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Coronary heart disease risks associated with high levels of HDL cholesterol.
Thursday,2014-05-29 14:36 America/Los_Angeles — poolea2
| Title | Coronary heart disease risks associated with high levels of HDL cholesterol. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Wilkins, JT, Ning, H, Stone, NJ, Criqui, MH, Zhao, L, Greenland, P, Lloyd-Jones, DM |
| Journal | J Am Heart Assoc |
| Volume | 3 |
| Issue | 2 |
| Pagination | e000519 |
| Date Published | 2014 Mar 13 |
| ISSN | 2047-9980 |
| Keywords | Aged, Biomarkers, Cholesterol, HDL, Coronary Disease, Female, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Prognosis, Proportional Hazards Models, Risk Assessment, Risk Factors, Time Factors, United States, Up-Regulation |
| Abstract | <p><b>BACKGROUND: </b>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).</p><p><b>METHODS AND RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.1161/JAHA.113.000519 |
| Alternate Journal | J Am Heart Assoc |
| PubMed ID | 24627418 |
| PubMed Central ID | PMC4187512 |
| Grant List | HHSN268201100001I / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268201100004I / HL / NHLBI NIH HHS / United States HHSN268201100046C / HL / NHLBI NIH HHS / United States AG-15928 / AG / NIA NIH HHS / United States HHSN268201100003C / WH / WHI NIH HHS / United States AG-20098 / AG / NIA NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States HHSN271201100004C / AG / NIA NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States HHSN268201100002C / WH / WHI NIH HHS / United States N01 HC-15103 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-45133 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States HHSN268201100002I / HL / NHLBI NIH HHS / United States R21 HL085375 / HL / NHLBI NIH HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States AG-023629 / AG / NIA NIH HHS / United States HHSN268201100001C / WH / WHI NIH HHS / United States HHSN268201100004C / WH / WHI NIH HHS / United States |