Association of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals

The EPOCH–JAPAN study

Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. Objective: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. Methods: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40–89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04–1.55 mmol/L (40–59 mg/dL) using a cohort-stratified Cox proportional hazards model. Results: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37–4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. Conclusion: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.

Original languageEnglish
Pages (from-to)674-684.e5
JournalJournal of Clinical Lipidology
Volume12
Issue number3
DOIs
Publication statusPublished - 01-05-2018

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HDL Cholesterol
Cohort Studies
Mortality
Cardiovascular Diseases
Cause of Death
Proportional Hazards Models
Coronary Disease
Stroke
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

Cite this

Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group. / Association of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals : The EPOCH–JAPAN study. In: Journal of Clinical Lipidology. 2018 ; Vol. 12, No. 3. pp. 674-684.e5.
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title = "Association of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals: The EPOCH–JAPAN study",
abstract = "Background: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. Objective: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. Methods: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40–89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04–1.55 mmol/L (40–59 mg/dL) using a cohort-stratified Cox proportional hazards model. Results: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95{\%} confidence interval: 1.37–4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. Conclusion: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.",
author = "{Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group} and Aya Hirata and Daisuke Sugiyama and Makoto Watanabe and Akiko Tamakoshi and Hiroyasu Iso and Kazuhiko Kotani and Masahiko Kiyama and Michiko Yamada and Shizukiyo Ishikawa and Yoshitaka Murakami and Katsuyuki Miura and Hirotsugu Ueshima and Tomonori Okamura and Hirotsugu Ueshima and Tomonori Okamura and Yutaka Imai and Takayoshi Ohkubo and Fujiko Irie and Hiroyasu Iso and Akihiko Kitamura and Toshiharu Ninomiya and Yutaka Kiyohara and Katsuyuki Miura and Yoshitaka Murakami and Hideaki Nakagawa and Takeo Nakayama and Akira Okayama and Toshimi Sairenchi and Shigeyuki Saitoh and Kiyomi Sakata and Akiko Tamakoshi and Ichiro Tsuji and Michiko Yamada and Masahiko Kiyama and Yoshihiro Miyamoto and Shizukiyo Ishikawa and Hiroshi Yatsuya",
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Association of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals : The EPOCH–JAPAN study. / Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group.

In: Journal of Clinical Lipidology, Vol. 12, No. 3, 01.05.2018, p. 674-684.e5.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals

T2 - The EPOCH–JAPAN study

AU - Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group

AU - Hirata, Aya

AU - Sugiyama, Daisuke

AU - Watanabe, Makoto

AU - Tamakoshi, Akiko

AU - Iso, Hiroyasu

AU - Kotani, Kazuhiko

AU - Kiyama, Masahiko

AU - Yamada, Michiko

AU - Ishikawa, Shizukiyo

AU - Murakami, Yoshitaka

AU - Miura, Katsuyuki

AU - Ueshima, Hirotsugu

AU - Okamura, Tomonori

AU - Ueshima, Hirotsugu

AU - Okamura, Tomonori

AU - Imai, Yutaka

AU - Ohkubo, Takayoshi

AU - Irie, Fujiko

AU - Iso, Hiroyasu

AU - Kitamura, Akihiko

AU - Ninomiya, Toshiharu

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

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. Objective: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. Methods: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40–89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04–1.55 mmol/L (40–59 mg/dL) using a cohort-stratified Cox proportional hazards model. Results: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37–4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. Conclusion: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.

AB - Background: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. Objective: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. Methods: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40–89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04–1.55 mmol/L (40–59 mg/dL) using a cohort-stratified Cox proportional hazards model. Results: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37–4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. Conclusion: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.

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U2 - 10.1016/j.jacl.2018.01.014

DO - 10.1016/j.jacl.2018.01.014

M3 - Article

VL - 12

SP - 674-684.e5

JO - Journal of Clinical Lipidology

JF - Journal of Clinical Lipidology

SN - 1933-2874

IS - 3

ER -