TY - JOUR
T1 - A pooled analysis of the association of isolated low levels of high-density lipoprotein cholesterol with cardiovascular mortality in Japan
AU - for the Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) Research Group
AU - Hirata, Takumi
AU - Sugiyama, Daisuke
AU - Nagasawa, Shin ya
AU - Murakami, Yoshitaka
AU - Saitoh, Shigeyuki
AU - Okayama, Akira
AU - Iso, Hiroyasu
AU - Irie, Fujiko
AU - Sairenchi, Toshimi
AU - Miyamoto, Yoshihiro
AU - Yamada, Michiko
AU - Ishikawa, Shizukiyo
AU - Miura, Katsuyuki
AU - Ueshima, Hirotsugu
AU - Okamura, Tomonori
AU - Ueshima, Hirotsugu
AU - Imai, Yutaka
AU - Ohkubo, Takayoshi
AU - Irie, Fujiko
AU - Kitamura, Akihiko
AU - Kiyohara, Yutaka
AU - Miura, Katsuyuki
AU - Murakami, Yoshitaka
AU - Nakagawa, Hideaki
AU - Nakayama, Takeo
AU - Okayama, Akira
AU - Sairenchi, Toshimi
AU - Saitoh, Shigeyuki
AU - Sakata, Kiyomi
AU - Tamakoshi, Akiko
AU - Tsuji, Ichiro
AU - Yamada, Michiko
AU - Kiyama, Masahiko
AU - Miyamoto, Yoshihiro
AU - Ishikawa, Shizukiyo
AU - Yatsuya, Hiroshi
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media Dordrecht.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Low levels of serum high-density lipoprotein cholesterol (HDL-C) have been shown to be associated with increased risk of coronary heart disease (CHD). However, because this is usually observed in the context of other lipid abnormalities, it is not known whether isolated low serum HDL-C levels are an independent risk factor for CHD. We performed a large pooled analysis in Japan using data from nine cohorts with 41,206 participants aged 40–89 years who were free of cardiovascular disease at baseline. We divided participants into three groups: isolated low HDL-C, non-isolated low HDL-C, and normal HDL-C. Cohort-stratified Cox proportional hazards models were used to estimate multivariate-adjusted hazard ratios (HRs) for death due to CHD, ischemic stroke, and intracranial cerebral hemorrhage; during a 12.9-year follow-up, we observed 355, 286, and 138 deaths, respectively, in these groups. Non-isolated low HDL-C was significantly associated with increased risk of CHD compared with normal HDL-C (HR 1.37, 95 % confidence interval (CI) 1.04–1.80); however, isolated low HDL-C was not. Although isolated low HDL-C was significantly associated with decreased risk of CHD (HR 0.51, 95 % CI 0.29–0.89) in women, it was significantly associated with increased risk of intracranial cerebral hemorrhage in all participants (HR 1.62, 95 % CI 1.04–2.53) and in men (HR 2.00, 95 % CI 1.04–3.83). In conclusion, isolated low HDL-C levels are not associated with increased risk of CHD in Japan. CHD risk may, therefore, be more strongly affected by serum total cholesterol levels in this population.
AB - Low levels of serum high-density lipoprotein cholesterol (HDL-C) have been shown to be associated with increased risk of coronary heart disease (CHD). However, because this is usually observed in the context of other lipid abnormalities, it is not known whether isolated low serum HDL-C levels are an independent risk factor for CHD. We performed a large pooled analysis in Japan using data from nine cohorts with 41,206 participants aged 40–89 years who were free of cardiovascular disease at baseline. We divided participants into three groups: isolated low HDL-C, non-isolated low HDL-C, and normal HDL-C. Cohort-stratified Cox proportional hazards models were used to estimate multivariate-adjusted hazard ratios (HRs) for death due to CHD, ischemic stroke, and intracranial cerebral hemorrhage; during a 12.9-year follow-up, we observed 355, 286, and 138 deaths, respectively, in these groups. Non-isolated low HDL-C was significantly associated with increased risk of CHD compared with normal HDL-C (HR 1.37, 95 % confidence interval (CI) 1.04–1.80); however, isolated low HDL-C was not. Although isolated low HDL-C was significantly associated with decreased risk of CHD (HR 0.51, 95 % CI 0.29–0.89) in women, it was significantly associated with increased risk of intracranial cerebral hemorrhage in all participants (HR 1.62, 95 % CI 1.04–2.53) and in men (HR 2.00, 95 % CI 1.04–3.83). In conclusion, isolated low HDL-C levels are not associated with increased risk of CHD in Japan. CHD risk may, therefore, be more strongly affected by serum total cholesterol levels in this population.
KW - Cardiovascular diseases
KW - Epidemiology
KW - High-density lipoprotein cholesterol
KW - Mortality
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U2 - 10.1007/s10654-016-0203-1
DO - 10.1007/s10654-016-0203-1
M3 - Article
C2 - 27709448
AN - SCOPUS:84990852431
SN - 0393-2990
VL - 32
SP - 547
EP - 557
JO - European Journal of Epidemiology
JF - European Journal of Epidemiology
IS - 7
ER -