HDL-C: Not an Accurate Predictor of Heart Disease?

High-density lipoprotein cholesterol (HDL-C) should not be the only lipid considered when determining cardiovascular disease (CVD) risk, according to a new study.

Although HDL-C levels have been used independently to predict CVD risk for many years, it is unclear how the levels of other lipids, such as low-density lipoprotein cholesterol (LDL-C) and triglycerides, factor into the relationship.
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To conduct their study, the researchers followed 3590 participants without known CVD in the Framingham Heart Study offspring cohort from 1987 to 2011.

Low HDL-C was categorized as less than 40 mg/dL in men and less than 50 mg/dL in women and was considered isolated if triglycerides and LDL-C levels were also low, at less than 100 mg/dL.

The researchers also examined higher thresholds for triglycerides (150 mg/dL or more) and LDL-C (130 mg/dL or more) and compared low and high levels of HDL-C to further understand its link to CVD risk.

The results showed that a higher CVD risk was present when low HDL-C was accompanied by:

• LDL-C levels of 100 mg/dL or higher and triglyceride levels of less than 100 mg/dL,
• Triglyceride levels of 100 mg/dL or more and LDL-C levels of less than 100 mg/dL, or
• Triglyceride and LDL-C levels of 100 mg/dL or more.

“CVD risk as a function of HDL-C phenotypes is modulated by other components of the lipid panel,” the researchers concluded.

—Amanda Balbi

Reference:

Bartlett J, Predazzi IM, Williams SM, et al. Is isolated low high-density lipoprotein cholesterol a cardiovascular disease risk factor?: new insights from the Framingham Offspring Study [published online May 10, 2016]. Circulation. doi:10.1161/CIRCOUTCOMES.115.002436.