Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies
Key result
Extremely high HDL cholesterol is linked to a ~106% higher all-cause mortality risk in men.
- HR 2.06
- 95% CI 1.44-2.95
- n=116,508
Why the study?
Does extreme high HDL cholesterol increase all-cause mortality in men and women?
Population
116,508 individuals from two prospective population-based studies
Comparison
Extreme high concentrations of HDL cholesterol vs HDL cholesterol concentrations associated with…
Design
Cohort
Follow-up
745,452 person-years
Authors
Discussion
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Implication
Extreme high HDL cholesterol concentrations are paradoxically associated with increased all-cause mortality in both men and women, demonstrating a U-shaped risk curve.
Study Design
Type
Cohort (n=116,508)
Multicenter
Yes
Structured PICO
Does extreme high HDL cholesterol increase all-cause mortality in men and women?
P
Population
116,508 men and women from two prospective population-based cohorts, followed for 745,452 person-years to assess the association between HDL cholesterol and mortality.
E
Exposure
Extreme high concentrations of HDL cholesterol (≥3.0 mmol/L [116 mg/dL] for men, ≥3.5 mmol/L [135 mg/dL] for women)
C
Comparator
HDL cholesterol concentrations associated with the lowest all-cause mortality (1.9 mmol/L [73 mg/dL] for men, 2.4 mmol/L [93 mg/dL] for women)
O
Outcome
All-cause mortalityhard clinical
Main Result
Hazard Ratio: 2.06 (95% CI 1.44–2.95)
Extreme high HDL cholesterol concentrations are paradoxically associated with increased all-cause mortality in both men and women, demonstrating a U-shaped risk curve.
Limitations
- These findings need confirmation in other studies.
Cite This Study
Madsen et al. (2017) conducted a cohort in General population (n=116,508). Extreme high high-density lipoprotein (HDL) cholesterol vs. Lowest risk HDL cholesterol concentrations (1.9 mmol/L in men, 2.4 mmol/L in women) was evaluated on All-cause mortality (HR 2.06, 95% CI 1.44-2.95). Extreme high HDL cholesterol concentrations were paradoxically associated with increased all-cause mortality in both men (HR 2.06; 95% CI 1.44-2.95) and women (HR 1.68; 95% CI 1.09-2.58).