HDL too excessive or low linked with CV occasion threat in males with hypertension


August 18, 2022

2 min learn


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Disclosures:
The authors report no related monetary disclosures.


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Amongst sufferers with scientific hypertension, researchers noticed higher threat for CV occasions amongst males with excessive and low HDL ranges in contrast with males with medium HDL, outlined as 40 mg/dL to 80 mg/dL.

The affiliation between HDL stage and CV threat in sufferers with hypertension was not noticed in ladies, in response to the examine revealed in Hypertension.



HDL blocks 2019

Supply: Adobe Inventory

Valentina Trimarco, of the division of neuroscience, reproductive sciences and dentistry at Federico II College in Naples, Italy, and colleagues wrote that prior research have postulated that for each 1 mg/dL improve in HDL, threat for CV demise is lowered 2% to three%.

“Within the algorithms at the moment used to calculate cardiovascular threat within the common inhabitants, HDL-C ranges are thought-about protecting,” the researchers wrote. “Our findings point out that at excessive ranges (ie, > 80 mg/dL), this protecting impact doesn’t seem to carry true and, in truth, might confer an elevated threat in male sufferers with hypertension.”

To raised perceive the connection between HDL and CV occasion threat in sufferers with hypertension, researchers utilized the Campania Salute Community, a big inhabitants with a excessive CV threat, well-characterized cardiometabolic measures and long-term follow-up.

CV occasions included main adversarial CV occasions, sudden cardiac demise, deadly and nonfatal MI or stroke, myocardial revascularization, HF hospitalization, carotid stenting, transient ischemic assault, de novo angina and atrial fibrillation.

The evaluation included 11,987 sufferers with hypertension (imply follow-up, 25.1 years) who have been divided into three teams by HDL ranges: low HDL of lower than 40 mg/dL; medium HDL of between 40 and 80 mg/dL; and excessive HDL of greater than 80 mg/dL.

The researchers famous that imply HDL was greater in ladies in contrast with males (54.4 mg/dL vs. 47.28 mg/dL; P < .0001).

Over a complete follow-up of 25,534 person-years, 245 CV occasions occurred, with the next prevalence in every HDL group:

  • 3.5% in these with excessive HDL;
  • 3.4% in these with low HDL (P < .08); and
  • 2.6% in these with medium HDL (P vs. high and low HDL = .02).

In different findings, researchers famous that the affiliation between elevated threat for CV occasions in sufferers with low or excessive HDL stage was not seen among the many ladies within the examine cohort.

“Our observations deal with an vital data hole within the subject: certainly, within the present algorithms used to calculate cardiovascular threat within the common inhabitants, HDL-C stage is taken into account as a protecting issue, whereas at very excessive ranges, this protecting impact doesn’t seem to carry true and, in truth, might confer an elevated threat,” the researchers wrote. “The elevated cardiovascular threat related to elevated ranges of HDL-C was not confirmed in feminine topics. Notably, we have to contemplate the low proportion of occasions (particularly within the feminine cohort), resulting in much less exact estimates in contrast with the general cohort.”



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