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Published on: October 12, 2017

Is elevated high-density lipoprotein cholesterol always good for coronary heart disease?

Yuhua Sun1, Yuejin Yang, Weidong Pei

  • 1Cardiovascular Institute and Fu Wai Heart Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Disease Control and Research, Beijing, China.

Clinical Cardiology
|November 16, 2007
PubMed

Insights

High-density lipoprotein cholesterol (HDL-C) may be an independent risk factor for unstable angina, particularly in older adults. However, HDL-C appears protective against coronary stenosis in younger individuals.

Area of Science:

  • Cardiology
  • Lipid Metabolism
  • Atherosclerosis Research

Background:

  • High-density lipoprotein (HDL) function, including paraoxonase and antioxidant activity, declines with age.
  • HDL's role in atherogenesis may differ across age groups in coronary heart disease (CHD) patients.

Purpose of the Study:

  • To investigate the differential role of high-density lipoprotein cholesterol (HDL-C) in coronary heart disease (CHD) across various age groups.
  • To analyze risk factors associated with CHD and resting unstable angina.

Main Methods:

  • Study included 225 CHD patients and 80 controls, plus 120 resting unstable angina and 68 stable angina patients.
  • Coronary angiography confirmed stenosis >/= 50% in major coronary arteries for CHD patients.
  • Risk factors for CHD and resting unstable angina were analyzed, with subgroup analysis by age.

Main Results:

  • Resting unstable angina patients had higher HDL-C levels than stable angina patients (p=0.032).
  • Elevated HDL-C was an independent risk factor for resting unstable angina (OR 10.19, p=0.003) after adjustments.
  • In patients <55 years, HDL-C was protective against CHD (OR 0.09, p=0.018), while in patients >/=55 years, high HDL-C was associated with resting unstable angina (OR 19.24, p=0.002).

Conclusions:

  • Elevated HDL-C may be an independent risk factor for resting unstable angina, especially in older individuals.
  • HDL-C likely plays a significant protective role against coronary stenosis in younger and middle-aged populations.
Abstract

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