Very High Levels of High-Density Lipoprotein Cholesterol and Cardiovascular Events in Japanese Population

A reduction in plasma high-density lipoprotein cholesterol (HDL-C) level accelerated the frequency of cardiovascular (CV) event, which was strongly enhanced in combination with an increased low-density lipoprotein cholesterol (LDL-C) level in the Framingham study populations 1) .The Japan Atherosclerosis Society Guidelines for the Diagnosis and Prevention of Atherosclerotic Cardiovascular Diseases 2012 (JAS Guidelines 2012) defined an HDL-C level of ＜40 mg/dL as hypo-HDL-cholesterolemia, which is correlated with an increased CV event rate based on the results of many clinical investigations 2) .Because the morbidity of CV event negatively correlated with HDL-C level, it is believed that subjects with very high HDL-C level (＞80 mg/dL) had a lower incidence of CV event or CV death.Although subjects with very high HDL-C level are frequently observed in Japan, little is known about the atherogenicity in patients with very high HDL-C level in Japanese dwellers.In the current study, Hirata et al. investigated the relationship between serum HDL categories including the very high HDL-C level (＞80 mg/dL) and all-cause/CV mortality for a long observational period from 10 to 20 years using the national cohort, surveillance study of "NIPPON DATA90" 3) .HDL-C level was not associated with all-cause mortality or stroke.As we suspected, the risk for coronary heart disease (CHD) in the high HDL-C group (1.56 -2.06 mmol/L; 60 -79 mg/dL) was lower than that in the reference group (1.04 -1.55 mmol/L; 40 -59 mg/dL) and hazard ratio was 0.51 in men, 0.33 in women, Very High Levels of High-Density Lipoprotein Cholesterol and Cardiovascular Events in Japanese Population