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U-Shaped HDL-C Mortality Curve Seen in Canada-Based Analysis

A population-based cohort study of >630,000 persons without cardiovascular disease has concluded that low and very high levels of HDL cholesterol correspond to an increased risk of death from both CV and non-CV causes, compared with intermediate LDL-C levels[1]. The effect was especially pronounced in men.

The study"s main finding is   of nonlinear, mostly U-shaped relationships between HDL-C levels and mortality in women and men, in which intermediate levels were associated with improved outcomes while risk was raised at higher and lower levels. But there were also strong relationships between HDL-C levels and such standard risk factors as age, sex, hypertension, diabetes, smoking, chronic obstructive pulmonary disease, exercise levels, body-mass index (BMI), and consumption of fruits, vegetables, and alcohol.That suggests multiple levels of confounding, which questions the independence of HDL-C as a CV risk marker, explained Ko, who presented the analysis at the American Heart Association (AHA) 2015 Scientific Sessions.

http://www.medscape.com/viewarticle/854528