Association of high-density lipoprotein cholesterol with all-cause and cause-specific mortality in a Chinese...

Area of Science:

• Cardiovascular Medicine
• Epidemiology
• Biochemistry

Background:

• High-density lipoprotein cholesterol (HDL-C) is typically inversely associated with cardiovascular disease (CVD) risk.
• Emerging evidence indicates extremely high HDL-C levels may paradoxically increase CVD incidence and mortality.
• This study investigates the association between HDL-C levels and mortality in a large Chinese cohort.

Purpose of the Study:

• To examine the relationship between HDL-C levels and all-cause mortality.
• To investigate the association of HDL-C with cause-specific mortality, including cardiovascular and cancer deaths.
• To determine an optimal HDL-C range for cardiovascular health in the Chinese population.

Main Methods:

• Utilized data from the China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) project, including 3,397,547 participants aged 35-75 years.
• Collected baseline HDL-C measurements and followed participants for a median of 3.9 years.
• Ascertained mortality data from national surveillance systems and vital registration records.

Main Results:

• Observed U-shaped associations between HDL-C levels and all-cause, cardiovascular, and cancer mortality.
• Significantly increased mortality risks were noted for HDL-C <30 mg/dL (HR 1.23 for all-cause) and HDL-C >90 mg/dL (HR 1.10 for all-cause).
• Specific U-shaped patterns were found for ischemic heart disease, ischemic stroke, and liver cancer, with abnormal HDL-C levels contributing to 3.25% of all-cause mortality.

Conclusions:

• Both low and high HDL-C levels are associated with increased all-cause and cause-specific mortality.
• Recommended an optimal HDL-C range of 50-79 mg/dL for Chinese adults.
• Emphasized the importance of managing both low and high HDL-C levels in individuals with dyslipidemia.