Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants
Abstract Background High-density lipoprotein cholesterol’s (HDL-C) long-held status as a cardiovascular disease (CVD) preventative has been called into question. Most of the evidence, however, focused on either the risk of death from CVD, or on single time point level of HDL-C. This study aimed to d...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-023-01805-8 |
| _version_ | 1797854050202419200 |
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| author | Hye Jun Kim Seogsong Jeong Yun Hwan Oh Sun Jae Park Yoosun Cho Sang Min Park |
| author_facet | Hye Jun Kim Seogsong Jeong Yun Hwan Oh Sun Jae Park Yoosun Cho Sang Min Park |
| author_sort | Hye Jun Kim |
| collection | DOAJ |
| description | Abstract Background High-density lipoprotein cholesterol’s (HDL-C) long-held status as a cardiovascular disease (CVD) preventative has been called into question. Most of the evidence, however, focused on either the risk of death from CVD, or on single time point level of HDL-C. This study aimed to determine the association between changes in HDL-C levels and incident CVD in individuals with high baseline HDL-C levels (≥ 60 mg/dL). Methods 77,134 people from the Korea National Health Insurance Service-Health Screening Cohort were followed for 517,515 person-years. Cox proportional hazards regression was used to evaluate the association between change in HDL-C levels and the risk of incident CVD. All participants were followed up until 31 December 2019, CVD, or death. Results Participants with the greatest increase in their HDL-C levels had higher risks of CVD (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.05–1.25) and CHD (aHR 1.27, CI 1.11–1.46) after adjusting for age, sex, household income, body mass index, hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol consumption, moderate-to-vigorous physical activity, Charlson comorbidity index, and total cholesterol than those with the lowest increase in HDL-C levels. Such association remained significant even among participants with decreased low-density lipoprotein cholesterol (LDL-C) levels for CHD (aHR 1.26, CI 1.03–1.53). Conclusions In people with already high HDL-C levels, additional increases in HDL-C levels may be associated with an increased risk of CVD. This finding held true irrespective of the change in their LDL-C levels. Increasing HDL-C levels may lead to unintentionally elevated risk of CVD. |
| first_indexed | 2024-04-09T20:00:48Z |
| format | Article |
| id | doaj.art-5b20a9518e69488983e49e395d43e28e |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-09T20:00:48Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-5b20a9518e69488983e49e395d43e28e2023-04-03T05:15:21ZengBMCCardiovascular Diabetology1475-28402023-03-0122111010.1186/s12933-023-01805-8Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participantsHye Jun Kim0Seogsong Jeong1Yun Hwan Oh2Sun Jae Park3Yoosun Cho4Sang Min Park5Department of Biomedical Sciences, Seoul National University College of MedicineDepartment of Biomedical Informatics, CHA University School of MedicineDepartment of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of MedicineDepartment of Biomedical Sciences, Seoul National University College of MedicineTotal Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDepartment of Biomedical Sciences, Seoul National University College of MedicineAbstract Background High-density lipoprotein cholesterol’s (HDL-C) long-held status as a cardiovascular disease (CVD) preventative has been called into question. Most of the evidence, however, focused on either the risk of death from CVD, or on single time point level of HDL-C. This study aimed to determine the association between changes in HDL-C levels and incident CVD in individuals with high baseline HDL-C levels (≥ 60 mg/dL). Methods 77,134 people from the Korea National Health Insurance Service-Health Screening Cohort were followed for 517,515 person-years. Cox proportional hazards regression was used to evaluate the association between change in HDL-C levels and the risk of incident CVD. All participants were followed up until 31 December 2019, CVD, or death. Results Participants with the greatest increase in their HDL-C levels had higher risks of CVD (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.05–1.25) and CHD (aHR 1.27, CI 1.11–1.46) after adjusting for age, sex, household income, body mass index, hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol consumption, moderate-to-vigorous physical activity, Charlson comorbidity index, and total cholesterol than those with the lowest increase in HDL-C levels. Such association remained significant even among participants with decreased low-density lipoprotein cholesterol (LDL-C) levels for CHD (aHR 1.26, CI 1.03–1.53). Conclusions In people with already high HDL-C levels, additional increases in HDL-C levels may be associated with an increased risk of CVD. This finding held true irrespective of the change in their LDL-C levels. Increasing HDL-C levels may lead to unintentionally elevated risk of CVD.https://doi.org/10.1186/s12933-023-01805-8Cholesterol, HDLPublic healthMass screeningCardiovascular diseasesCoronary heart diseaseStroke. |
| spellingShingle | Hye Jun Kim Seogsong Jeong Yun Hwan Oh Sun Jae Park Yoosun Cho Sang Min Park Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants Cardiovascular Diabetology Cholesterol, HDL Public health Mass screening Cardiovascular diseases Coronary heart disease Stroke. |
| title | Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants |
| title_full | Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants |
| title_fullStr | Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants |
| title_full_unstemmed | Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants |
| title_short | Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants |
| title_sort | changes in high density lipoprotein cholesterol with risk of cardiovascular disease among initially high density lipoprotein high participants |
| topic | Cholesterol, HDL Public health Mass screening Cardiovascular diseases Coronary heart disease Stroke. |
| url | https://doi.org/10.1186/s12933-023-01805-8 |
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