Cardiac artery disease

Too much is never good: how the “healthy” HDL-cholesterol (HDL-c) can turn into a bad risk

A big prospective, multicenter, cohort study, conducted in the UK and the USA with 14.478 CAD (cardiac artery disease) patients with a median follow-up of 6.7 (UK) to 8.9 (USA) years has shown that very high HDL-c paradoxically are associated with higher mortality in individuals with CAD. This was also the case with low HDL-c levels.

Normally HDL-c is considered to have a protective role with concern to CAD in opposite to the “bad” LDL-c. A higher HDL-c thus is associated with a lower CAD risk. However, as it appears now a very high HDL-c shows a complete different picture and is a big risk for mortality in CAD patients.

In a recent presentation at the European congress of Internal Medicine ( ECIM) from Spain a 10-year follow-up of 1.849.087 workers with a mean age of 36.7 years, 67.8 % men, was reported. It was investigated how low and high HDL-c were associated with the development of a malignant neoplasm. In this large group of working people the risk of neoplasia (fatal or not) in indivuals with extreme HDL-c appeared to be much higher (5 times) than in the group with average HDL-c. In the group with a low HDL-c there was only a modest increased risk (1.2 times higher).