“Good” Cholesterol Concentrations Linked to Increased Mortality Risk
Very high and very low high-density lipoprotein (HDL) cholesterol concentrations are associated with an increased risk for all-cause mortality for men and women, according to a recent study.
In their study, the researchers analyzed data from 52,268 men and 64,240 women involved in either the Copenhagen City Heart Study or the Copenhagen General Population study. Mortality related to any cause was determined using the Danish Civil Registration System.
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During the median 6 years of follow-up, 5619 men and 5059 women died.
Analyses showed that the association between HDL cholesterol concentrations and all-cause mortality for men and women was U-shaped, with extreme high and low concentrations associated with the highest risk.
The concentration of HDL cholesterol associated with the lowest all-cause mortality for men was 1.9 mmol/L and for women was 2.4 mmol/L.
Compared with those with the lowest risk, the adjusted hazard ratios for all-cause mortality were 1.36 for men with HDL cholesterol concentrations of 2.5 to 2.99 mmol/L, 2.06 for men with HDL cholesterol concentrations of 3.0 mmol/L or greater, 1.10 for women with HDL cholesterol concentrations of 3.0 to 3.49 mmol/L, and 1.68 for women with HDL cholesterol concentrations of 3.5 mmol/L or greater.
“It appears that we need to remove the focus from HDL as an important health indicator in research, at hospitals and at the general practitioner. These are the smallest lipoproteins in the blood, and perhaps we ought to examine some of the larger ones instead,” the researchers concluded. “For example, looking at blood levels of triglyceride and LDL, the ‘bad’ cholesterol, are probably better health indicators.”2
—Melissa Weiss
Reference:
1) Madsen CM, Varbo A, Nordestgaard BG. Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies. Eur Heart J. 2017;38(32): 2478–2486. https://doi.org/10.1093/eurheartj/ehx163.
2) Researchers link high levels of ‘good’ cholesterol with excessive mortality [press release]. Copenhagen, DK:University of Copenhagen; August 23, 2017. http://healthsciences.ku.dk/news/2017/08/researchers-link-high-levels-of-good-cholesterol-with-excessive-mortality/. Accessed August 24, 2017.