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Low HDL, high triglycerides contribute to residual CHD risk

By jeremyc | August 17, 2010

Source: MedWire News

High levels of triglycerides and low levels of high-density lipoprotein (HDL) cholesterol have a “strong and synergistic” influence on coronary heart disease (CHD) risk in the presence of well-controlled low-density lipoprotein (LDL) cholesterol, US scientists believe.

Vincent Carey (Brigham and Women’s Hospital, Boston, Massachusetts) and colleagues sought to quantify the relative contributions of triglycerides and HDL cholesterol to the residual risk for CHD after reducing LDL cholesterol to guideline-recommended levels.

From a hospital database they identified 170 patients with CHD (cases) and 175 patients without CHD (controls), all of whom had LDL cholesterol levels below 130 mg/dl (3.4 mmol/l). Specifically, the mean LDL cholesterol level was 73 mg/dl (1.9 mmol/l) in cases and 87 mg/dl (2.2 mmol/l) in controls.

Writing in the American Journal of Cardiology, Carey et al report that the risk for CHD increased by around 20% for each 23-mg/dl (0.26-mmol/l) increase in triglycerides, and decreased by around 40% for each 7.5-mg/dl (0.19-mmol/l) decrease in HDL cholesterol.

Logistic regression analysis revealed that these two risk factors interacted in a synergistic manner, such that the risk for CHD was increased around 10-fold in people in the highest quintile of triglycerides (>190 mg/dl; 2.14 mmol/l) and the lowest quintile of HDL cholesterol (<30 mg/dl; 0.78 mmol/l).

In addition, the risk for CHD associated with triglycerides and HDL cholesterol was similar in people with the lowest levels of LDL cholesterol (<70 mg/dl; 1.8 mmol/l) to that in people with higher LDL cholesterol levels.

Carey and team say their results “provide new evidence of the residual risk of disease associated with high triglycerides and low HDL cholesterol levels in the presence of LDL cholesterol control.”

They conclude: “These findings contribute to the rationale for considering low HDL and high triglyceride levels, especially when they occur together, in quantifying the risk level to select the type and intensity of treatment.”

Topics: | Cholesterol |

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