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Objective <p>To evaluate the association between very high high-density lipoprotein cholesterol (HDL-C) levels and cardiovascular mortality in a general adult population.</p> Methods <p>In this retrospective cohort study, 3,758 adults undergoing lipid profiling at a tertiary care center were categorized into five HDL-C groups: Very Low (&lt; 30&#xa0;mg/dL), Low (30–49&#xa0;mg/dL), Normal (50–69&#xa0;mg/dL), High (70–89&#xa0;mg/dL), and Very High (≥ 90&#xa0;mg/dL in men or ≥ 110&#xa0;mg/dL in women). Demographic, clinical, and laboratory data were collected. The primary outcome was cardiovascular mortality over a median follow-up of 5.9&#xa0;years. Kaplan–Meier survival curves and Cox proportional hazards models were used to assess associations, adjusting for age, sex, comorbidities, and medications.</p> Results <p>The Very High HDL-C group demonstrated the highest cardiovascular mortality rate (11.3 per 1,000 person-years) and significantly reduced survival compared to the Normal group (log-rank p = 0.00028). Multivariable analysis revealed that very high HDL-C was associated with increased cardiovascular mortality (adjusted HR: 1.52; 95% CI 1.04–2.24; p = 0.03). Subgroup analyses showed elevated risk in older adults, diabetics, and non-statin users.</p> Conclusion <p>Extremely high HDL-C levels were independently associated with increased cardiovascular mortality, suggesting a U-shaped relationship. These findings warrant cautious interpretation of high HDL-C values in clinical practice.</p>

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Association between very high HDL-C levels and cardiovascular mortality

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月31日

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  • Sahrish Shaikh,
  • Farman Ali,
  • Sadam Hussain Shaikh,
  • Sartajudin Shaikh,
  • Laraib Fatima,
  • Ghulam Qadir,
  • F. N. U. Simran,
  • Abida Perveen,
  • Jahanzeb Malik

摘要

Objective

To evaluate the association between very high high-density lipoprotein cholesterol (HDL-C) levels and cardiovascular mortality in a general adult population.

Methods

In this retrospective cohort study, 3,758 adults undergoing lipid profiling at a tertiary care center were categorized into five HDL-C groups: Very Low (< 30 mg/dL), Low (30–49 mg/dL), Normal (50–69 mg/dL), High (70–89 mg/dL), and Very High (≥ 90 mg/dL in men or ≥ 110 mg/dL in women). Demographic, clinical, and laboratory data were collected. The primary outcome was cardiovascular mortality over a median follow-up of 5.9 years. Kaplan–Meier survival curves and Cox proportional hazards models were used to assess associations, adjusting for age, sex, comorbidities, and medications.

Results

The Very High HDL-C group demonstrated the highest cardiovascular mortality rate (11.3 per 1,000 person-years) and significantly reduced survival compared to the Normal group (log-rank p = 0.00028). Multivariable analysis revealed that very high HDL-C was associated with increased cardiovascular mortality (adjusted HR: 1.52; 95% CI 1.04–2.24; p = 0.03). Subgroup analyses showed elevated risk in older adults, diabetics, and non-statin users.

Conclusion

Extremely high HDL-C levels were independently associated with increased cardiovascular mortality, suggesting a U-shaped relationship. These findings warrant cautious interpretation of high HDL-C values in clinical practice.