Association of High-Density Lipoprotein Parameters and Risk of Heart Failure: A Multicohort Analysis

Area of Science:

• Cardiovascular Medicine
• Lipid Metabolism
• Heart Failure Research

Background:

• High-density lipoprotein (HDL) is traditionally assessed by cholesterol concentration (HDL-C).
• HDL-C has an inverse relationship with atherosclerotic cardiovascular disease.
• The role of HDL particle concentration (HDL-P) and size (HDL-size) in heart failure (HF) risk is less understood.

Purpose of the Study:

• To investigate the association between HDL particle concentration (HDL-P), HDL particle size (HDL-size), HDL cholesterol (HDL-C), and cholesterol content per particle (HDL-C/HDL-P) with overall heart failure (HF) risk.
• To examine these associations in relation to specific HF subtypes: HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).

Main Methods:

• Analysis of data from four large cohort studies: Atherosclerosis Risk In Communities, Dallas Heart Study, Multi-Ethnic Study of Atherosclerosis, and Prevention of Renal and Vascular End-stage Disease.
• Inclusion of participants without a prior history of HF.
• Utilized adjusted Cox proportional hazards models to assess the associations of HDL-P, HDL-size, HDL-C, and HDL-C/HDL-P with incident HF events.

Main Results:

• Among 16,925 participants followed for a median of 11.4 years, 612 incident HF events occurred.
• Higher HDL-P was significantly associated with a lower risk of overall HF (HR: 0.76).
• Larger HDL-size was significantly associated with a higher risk of overall HF (HR: 1.27).
• No significant association was found between HDL-C and HF risk.
• Higher HDL-C/HDL-P was significantly associated with increased overall HF risk (HR: 1.29).

Conclusions:

• Increased HDL particle concentration (HDL-P) is associated with a reduced risk of heart failure.
• Larger HDL particle size is linked to an elevated risk of heart failure.
• HDL cholesterol (HDL-C) levels did not show a significant association with HF risk after adjusting for cardiovascular risk factors.