Isolated low HDL-C and the risk of coronary artery disease

January 01, 0001

Isolated low HDL-C and the risk of coronary artery disease

There has been the suggestion that a novel lipoprotein phenotype, isolated low HDL-C occurs predominantly in Asian populations and may be linked with increased risk of coronary artery disease. This international group of researchers sought to characterize the occurrence of this phenotype and quantify any coronary artery disease using data from 220 060 participants in 37 studies from the Asia-Pacific region.

The researchers found: "Low HDL-C (HDL <1.03 mmol/L in men and <1.30 mmol/L in women) was seen among 33.1% of Asians versus 27.0% of non-Asians. The prevalence of low HDL-C in the absence of other lipid abnormalities (isolated low HDL-C) was higher in Asians compared with non-Asians: 22.4% versus 14.5%, respectively. During 6.8 years of follow-up, there were 574 coronary heart disease and 739 stroke events. There was an inverse relationship between low HDL-C with coronary heart disease in all individuals (hazard ratio, 1.57). In Asians, isolated low levels of HDL-C were as strongly associated with coronary heart disease risk as low levels of HDL-C combined with other lipid abnormalities (hazard ratio, 1.67 versus 1.63, respectively). There was no association between low HDL-C and stroke risk in this population (hazard ratio, 0.95 with nonisolated low HDL-C and 0.81 with isolated low HDL- C)."

The researchers concluded: "Isolated low HDL-C is a novel lipid phenotype that appears to be more prevalent among Asian populations, in whom it is associated with increased coronary risk. Further investigation into this type of dyslipidemia is warranted."

This study identifies a lipoprotein phenotype that is associated with increased risk of coronary artery disease

For the full abstract, click here.

Circulation 124(19):2056-2064, 8 November 2011 © 2011 American Heart Association, Inc.
Isolated Low Levels of High-Density Lipoprotein Cholesterol Are Associated With an Increased Risk of Coronary Heart Disease An Individual Participant Data Meta-Analysis of 23 Studies in the Asia-Pacific Region. Rachel R. Huxley, Federica Barzi, Tai Hing Lam, et al. Correspondence to Rachel Huxley: rhuxley@umn.edu

Category: K. Circulatory. Keywords: high-density lipoprotein, lipid, cholesterol, HDL, HDL-C, coronary artery disease, meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 22 November 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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