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Low plasma levels of HDL-C have consistently been identified as a predictor of CVD risk. However, the impact of high HDL-C on reducing CVD risk is controversial, with some studies indicating a U-shaped risk pattern. So, we aim to investigate whether the U-shaped risk pattern is applicable to the Korean population. We conducted a 16-year follow-up on a community-based cohort, excluding individuals with a history of cancer, CVD, CKD (GFR 30 mL/min), or currently on lipid-lowering medication. Participants were categorized into 4 groups : HDL 40, 40-60, 60-80, and 80 mg/dL. The primary endpoint was incident CVD, which includes acute myocardial infarction, coronary artery disease, and cerebrovascular disease. The secondary endpoint was carotid IMT. Hazard ratios for incident CVD (with reference to HDL-C 40 mg/dL) were 0.81 (P=0.03), 0.77 (P=0.045), and 0.31 (P=0.045) for the 40-60 mg/dL, 60-80 mg/dL, and 80 mg/dL groups, respectively. Both left and right carotid IMT inversely correlated with HDL-C groups. In this study, we observed that individuals with very high HDL-C plasma level have a lower risk of CVD in the Korean population. Elevated levels of HDL-C are associated with thinner carotid IMT, indicating reduced future CVD risk. Compared to Western populations, Koreans exhibit significantly lower CVD risk with very high HDL-C levels. Disclosure S. Yoo: None. J. Moon: None.
YOO et al. (Fri,) studied this question.