{"id":3714,"date":"2017-12-17T00:00:00","date_gmt":"2017-12-17T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/association-of-high-density-lipoprotein-cholesterol-with-non-fatal-cardiac-and-non-cardiac-events-a-canheart-substudy\/"},"modified":"2023-06-14T19:36:54","modified_gmt":"2023-06-14T23:36:54","slug":"association-of-high-density-lipoprotein-cholesterol-with-non-fatal-cardiac-and-non-cardiac-events-a-canheart-substudy","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-of-high-density-lipoprotein-cholesterol-with-non-fatal-cardiac-and-non-cardiac-events-a-canheart-substudy\/","title":{"rendered":"Association of high-density lipoprotein cholesterol with non-fatal cardiac and non-cardiac events: a CANHEART substudy"},"content":{"rendered":"<p><strong>Background <\/strong>&#x2014; Emerging evidence has questioned the role of high-density lipoprotein cholesterol (HDL-C) as an independent and modifiable risk factor for cardiovascular disease. We sought to understand the relationship between HDL-C levels and subsequent non-fatal clinical events.<\/p>\n<p><strong>Methods<\/strong> &#x2014; Individuals without prior cardiovascular disease or cancer were identified. Outcomes of interest were classified as non-fatal cardiovascular, cancer and infectious. Sex-stratified, multivariable, cause-specific Cox proportional hazards models were created. The reference level HDL-C for both women and men was 51-60 mg\/dL.<\/p>\n<p><strong>Results<\/strong> &#x2014; Our cohort consisted of 631 762 individuals. For cardiovascular events, there was a consistent inverse relationship, with higher adjusted HRs for the lower HDL-C strata in both men and women. This relationship was also seen in the composite of non-cardiovascular outcomes. In women, the HR in the &lt;30 mg\/dL HDL-C category was 2.10 (95% CI 1.66 to 2.57) and 1.86 (95% CI 1.27 to 2.72) for cardiovascular and non-cardiovascular outcomes, respectively; in contrast, in the &gt;90 mg\/dL group, it was 0.87 (95% CI 0.74 to 1.02) and 0.81 (95% CI 0.63 to 1.06). For men, HRs were 2.02 (95% CI 1.79 to 2.28) and 1.84 (95% CI 1.47 to 2.31) in the &lt;30 mg\/dL HDL-C category for cardiovascular and non-cardiovascular outcomes, respectively, compared with 0.73 (95% CI 0.53 to 1.00) and 1.07 (95% CI 0.67 to 1.70) in the &gt;90 mg\/dL group.<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; We found an inverse relationship between HDL-C and a wide spectrum of non-fatal outcomes, suggesting that HDL-C is a heavily confounded factor that may be a marker of poor overall health, rather than an independent and modifiable risk factor.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Emerging evidence has questioned the role of high-density lipoprotein cholesterol (HDL-C) as an independent and modifiable risk factor for cardiovascular disease. We sought to understand the relationship between HDL-C levels and subsequent non-fatal clinical events. Methods &#x2014; Individuals without prior cardiovascular disease or cancer were identified. Outcomes of interest were classified as non-fatal [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3714","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Wijeysundera HC, Koh M, Alter DA, Austin PC, Jackevicius CA, Tu JV, Ko DT. <em>Open Heart<\/em>. 2017; 4(2):e000731. Epub 2017 Dec 17.","source_url":"http:\/\/openheart.bmj.com\/content\/4\/2\/e000731","ices_scientist":[1146,1281,1385,1381,1133,1140],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"11BFC2D0-8AAB-41F9-BC20-552096420680","sitecore_item_name":"Association-of-high-density-lipoprotein-cholesterol-with-non-fatal-cardiac-and-non-cardiac-events","sitecore_field_values":"{\n  \"Title\": \"Association of high-density lipoprotein cholesterol with non-fatal cardiac and non-cardiac events: a CANHEART substudy\",\n  \"Short title\": \"Association of high-density\",\n  \"Citation\": \"<p>Wijeysundera HC, Koh M, Alter DA, Austin PC, Jackevicius CA, Tu JV, Ko DT. <em>Open Heart<\/em>. 2017; 4(2):e000731. Epub 2017 Dec 17.<\/p>\",\n  \"Abstract\": \"<p><strong>Background <\/strong>&mdash; Emerging evidence has questioned the role of high-density lipoprotein cholesterol (HDL-C) as an independent and modifiable risk factor for cardiovascular disease. We sought to understand the relationship between HDL-C levels and subsequent non-fatal clinical events.<\/p>n<p><strong>Methods<\/strong> &mdash; Individuals without prior cardiovascular disease or cancer were identified. Outcomes of interest were classified as non-fatal cardiovascular, cancer and infectious. Sex-stratified, multivariable, cause-specific Cox proportional hazards models were created. The reference level HDL-C for both women and men was 51-60 mg\/dL.<\/p>n<p><strong>Results<\/strong> &mdash; Our cohort consisted of 631 762 individuals. For cardiovascular events, there was a consistent inverse relationship, with higher adjusted HRs for the lower HDL-C strata in both men and women. This relationship was also seen in the composite of non-cardiovascular outcomes. In women, the HR in the &lt;30 mg\/dL HDL-C category was 2.10 (95% CI 1.66 to 2.57) and 1.86 (95% CI 1.27 to 2.72) for cardiovascular and non-cardiovascular outcomes, respectively; in contrast, in the &gt;90 mg\/dL group, it was 0.87 (95% CI 0.74 to 1.02) and 0.81 (95% CI 0.63 to 1.06). For men, HRs were 2.02 (95% CI 1.79 to 2.28) and 1.84 (95% CI 1.47 to 2.31) in the &lt;30 mg\/dL HDL-C category for cardiovascular and non-cardiovascular outcomes, respectively, compared with 0.73 (95% CI 0.53 to 1.00) and 1.07 (95% CI 0.67 to 1.70) in the &gt;90 mg\/dL group.<\/p>n<p><strong>Conclusions<\/strong> &mdash; We found an inverse relationship between HDL-C and a wide spectrum of non-fatal outcomes, suggesting that HDL-C is a heavily confounded factor that may be a marker of poor overall health, rather than an independent and modifiable risk factor.<\/p>n<p><a href=\"http:\/\/openheart.bmj.com\/content\/4\/2\/e000731\" title=\"Opens to full text in HTML\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{B3827152-93D1-4FB2-B106-590CB331A264}|{956599EC-5699-41D3-9375-E0B6C25B12D5}|{BA86E62A-3468-443D-939F-34A9EFA7B7AA}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{5178A761-5208-4E70-ABF8-146FCEB83294}|{8C2597F4-2B41-4E87-9F28-6887C689651B}|{5347DD83-0742-46B5-B0AC-4EF2A329F89E}\",\n  \"Posted Date\": \"20171217T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2017\/December\/Association-of-high-density-lipoprotein-cholesterol-with-non-fatal-cardiac-and-non-cardiac-events"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association of high-density lipoprotein cholesterol with non-fatal cardiac and non-cardiac events: a CANHEART substudy<\/title>\n<meta name=\"description\" content=\"Background &#x2014; 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