HDL cholesterol and risk of all-cause mortality in the general population. Based on 52 268 men and 64 240 women from the Copenhagen General Population Study and the Copenhagen City Heart Study combined. Hazard ratio (solid line) and 95% confidence interval (dashed lines) from age and study adjusted Cox regression using restricted cubic splines. The concentration of HDL cholesterol associated with lowest mortality was used as reference. The light blue area indicates the distribution of HDL cholesterol concentrations in men and women. CI, confidence interval; HDL, high-density lipoprotein.
HDL might not be as good as we think. In any case, the results of a new study from the University of Copenhagen seriously contradict the assumption that high levels of HDL in the blood are only a good thing. The researchers have shown that people with extremely high levels of good cholesterol have a higher mortality rate than people with normal levels. For men with extremely high levels, the mortality rate was 106% higher than for the normal group. For women with extremely high levels, the mortality rate was 68% higher. Men in the next group, with very high levels, also had a 36% higher mortality rate.
They analysed data for 116,000 subjects from the Copenhagen City Heart Study and the Copenhagen General Population Study, in combination with mortality data from the Danish Civil Registration System. They followed the subjects for ~ 6 years, and based the study on just over 10,500 deaths. The researchers were able to calculate the mortality rate based on these deaths and medical information on the subjects.
0.4% of the men and 0.3% of the women covered by the study had an extremely high level of HDL in their blood, and a further 1.9% of the men had a very high level. The study also found excessive mortality for people with extremely low levels of HDL in the blood. The people with medium levels of HDL in the blood had the lowest mortality. For men, this level was 1.9 mmol/L. For women, it was 2.4 mmol/L.
“It appears that we need to remove the focus from HDL as an important health indicator in research, at hospitals and at the general practitioner. These are the smallest lipoproteins in the blood, and perhaps we ought to examine some of the larger ones instead. For example, looking at blood levels of triglyceride and LDL, the ‘bad’ cholesterol, are probably better health indicators,” he notes. The new study examines the statistical correlation between mortality and HDL levels. It therefore cannot explain why people with extremely high or low HDL levels have higher mortality. http://healthsciences.ku.dk/news/2017/08/researchers-link-high-levels-of-good-cholesterol-with-excessive-mortality/ http://dx.doi.org/10.1093/eurheartj/ehx163
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