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Published on: October 12, 2017
Reevaluating elevated HDL cholesterol levels in healthy older persons as a risk factor for various disease states
1The School of International Medical Technology of Shanghai Sanda University Shanghai 201209, China.
Insights
High levels of high-density lipoprotein cholesterol (HDL-C) may increase health risks in the elderly, including fractures and dementia. Current understanding of HDL cholesterol benefits needs revision for older adults.
Area of Science:
- Gerontology
- Cardiovascular Science
- Biochemistry
Background:
- High-density lipoprotein cholesterol (HDL-C) is traditionally considered protective against cardiovascular disease.
- The established view of universal HDL-C benefits is being re-evaluated, particularly in aging populations.
Purpose of the Study:
- To review the role of HDL-C in the elderly.
- To question the assumption of ubiquitous health benefits of HDL cholesterol in older adults.
Main Methods:
- Analysis of large population-based studies, including the ASPREE trial and UK Biobank.
- Review of existing literature on HDL-C and health outcomes in the elderly.
Main Results:
- Elevated HDL-C levels are associated with increased risks of fractures, dementia, and cardiovascular disease in the elderly.
- These associations appear more pronounced in older men.
- Potential mechanisms involve cholesterol crystallization and impaired HDL particle function.
Conclusions:
- The understanding of HDL-C's role in the elderly requires refinement.
- Clinical guidelines and risk assessment strategies for older populations may need adjustments regarding HDL-C levels.
Abstract:
This article reviews the role of high-density lipoprotein cholesterol (HDL-C) in the elderly population, questioning the established view that advocates the ubiquitous health benefits of HDL cholesterol. High levels of HDL-C have been found to be associated with an increased risk of debilitating fractures, dementia, and cardiovascular disease, predominantly affecting older men, through the use of large population-based studies such as the ASPREE trial and the UK Biobank. Possible mechanisms are closely linked to cholesterol crystallization and altered HDL particle function. These findings call for a refinement of the understanding of high-density lipoprotein cholesterol (HDL-C), which implies adjustments to clinical guidelines and risk assessment strategies in older populations.
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