Association Between HDL Cholesterol Changes and Cardiovascular Event Risk: A Nationwide Health Screening Cohort in...

Area of Science:

• Cardiology
• Preventive Medicine
• Biochemistry

Background:

• Low high-density lipoprotein cholesterol (HDL-C) is a known cardiovascular risk factor.
• Longitudinal changes in HDL-C and their cardiovascular impact are not fully understood.
• Metabolic status, lifestyle, and medications influence HDL-C levels over time.

Purpose of the Study:

• To investigate the association between longitudinal changes in HDL-C and incident cardiovascular disease (CVD).
• To evaluate the cardiovascular risk associated with different patterns of HDL-C change over time.
• To determine if serial HDL-C measurements improve CVD risk prediction.

Main Methods:

• Retrospective cohort study utilizing the JMDC Claims Database (2005-2021).
• Included 3,387,924 adults with at least two health checkups.
• Categorized participants by HDL-C change (persistently low, low-to-normal, normal-to-low, persistently normal) and analyzed incident composite CVD using Cox models.

Main Results:

• Persistently low HDL-C was linked to the highest CVD risk (HR 1.15).
• Both low-to-normal and normal-to-low HDL-C groups showed increased CVD risks.
• Myocardial infarction risk was most strongly associated with HDL-C patterns; stroke association was less consistent.

Conclusions:

• Longitudinal HDL-C changes are significantly associated with cardiovascular risk.
• Persistently low HDL-C poses the greatest risk.
• Serial HDL-C monitoring may enhance cardiovascular risk assessment beyond baseline values.