Aya Hirata1, Daisuke Sugiyama1, Makoto Watanabe2, Akiko Tamakoshi3, Hiroyasu Iso4, Kazuhiko Kotani5, Masahiko Kiyama6, Michiko Yamada7, Shizukiyo Ishikawa5, Yoshitaka Murakami8, Katsuyuki Miura9, Hirotsugu Ueshima9, Tomonori Okamura10. 1. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan. 2. Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan. 3. Department of Public Health, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. 4. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. 5. Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan. 6. Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan. 7. Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan. 8. Department of Medical Statistics, Toho University School of Medicine, Tokyo, Japan. 9. Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan. 10. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan. Electronic address: okamura@z6.keio.jp.
Abstract
BACKGROUND: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. OBJECTIVE: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. METHODS: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40-89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04-1.55 mmol/L (40-59 mg/dL) using a cohort-stratified Cox proportional hazards model. RESULTS: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37-4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. CONCLUSION: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.
BACKGROUND: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. OBJECTIVE: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. METHODS: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40-89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04-1.55 mmol/L (40-59 mg/dL) using a cohort-stratified Cox proportional hazards model. RESULTS: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37-4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. CONCLUSION: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.
Authors: L Liu; M Han; R Qie; Q Li; X Zhang; J Zhang; S Zhan; L Zhang; Z Xu; C Zhang; F Hong Journal: J Endocrinol Invest Date: 2021-10-21 Impact factor: 4.256
Authors: Mary F Feitosa; Kathryn L Lunetta; Lihua Wang; Mary K Wojczynski; Candace M Kammerer; Thomas Perls; Nicole Schupf; Kaare Christensen; Joanne M Murabito; Michael A Province Journal: Atherosclerosis Date: 2020-02-14 Impact factor: 5.162
Authors: Daniel B Rosoff; Katrin Charlet; Jeesun Jung; Jisoo Lee; Christine Muench; Audrey Luo; Martha Longley; Kelsey L Mauro; Falk W Lohoff Journal: JAMA Netw Open Date: 2019-06-05