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Published on: October 12, 2017

Isolated Low Levels of High-density Lipoprotein Cholesterol are Associated with an Increased Risk of Ischemic

Yasuharu Tabara1,2, Sayaka Nagao-Sato1, Aya Shoji-Asahina1

  • 1Graduate School of Public Health, Shizuoka Graduate University of Public Health.

Journal of Atherosclerosis and Thrombosis
|July 5, 2026
PubMed

Insights

Isolated low high-density lipoprotein cholesterol (HDL-C) is linked to increased coronary artery disease (CAD) risk. It may also increase ischemic stroke risk in younger men, despite normal triglyceride and LDL-C levels.

Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Public Health

Background:

  • Isolated low high-density lipoprotein cholesterol (HDL-C) is defined by low HDL-C with normal triglyceride and low-density lipoprotein cholesterol (LDL-C) levels.
  • The prognostic significance of isolated low HDL-C remains debated.
  • Understanding its association with cardiovascular events is crucial for risk stratification.

Purpose of the Study:

  • To investigate the association between isolated low HDL-C and the incidence of coronary artery disease (CAD) and stroke.
  • To clarify the prognostic value of isolated low HDL-C in a large population.

Main Methods:

  • A cohort study of 496,973 Japanese individuals was conducted.
  • Data were sourced from municipal health insurance programs, including annual health checkups and claims.
  • Isolated low HDL-C was defined as HDL-C <40 mg/dL with normal triglyceride and LDL-C levels.

Main Results:

  • Isolated low HDL-C was identified in 1.3% of the participants.
  • Isolated low HDL-C showed an independent association with increased CAD incidence (HR=1.87).
  • While not associated with overall stroke incidence, it was linked to ischemic stroke in men and those under 65.

Conclusions:

  • Isolated low HDL-C is an independent risk factor for coronary artery disease (CAD).
  • It may also contribute to ischemic stroke risk, particularly in specific subgroups.
  • These findings highlight the importance of considering isolated low HDL-C in cardiovascular risk assessment.
Abstract

Keywords:
Coronary artery diseaseGeneral populationHemorrhagic strokeHigh-density lipoprotein cholesterolIschemic stroke

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