Prospective studies on the relationship between high-density lipoprotein cholesterol and cardiovascular risk: a systematic review

Abstract

Epidemiological studies have extensively evaluated the association between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease (CVD) risk. The objective of this systematic review was to enumerate the number of original prospective studies that showed a significant association between HDL-C and CVD risk and provided evidence of the consistency of this association across other lipid risk factors. A systematic MEDLINE literature search identified 53 prospective cohort and five nested case-control studies that provided multivariate assessments of the association between HDL-C and CVD risk. Among these 58 prospective studies, 31 studies found a significant inverse association between HDL-C and CVD risk for all CVD outcomes and subpopulations studied, whereas 17 studies found a significant association for some CVD outcomes and/or subpopulations assessed. The ratio of studies that found a significant association out of the total studies identified was similar across all CVD outcomes, although there was less evidence for stroke and atherosclerotic outcomes. Only seven studies tested for the consistency of this association across other lipid risk factors, of which six studies suggested that the association was consistent across other lipid levels. In conclusion, the association between HDL-C and CVD risk is significant and strong, although further evidence may be needed to establish whether this association is consistent across other lipid risk factors. Furthermore, uncertainties remain regarding the mechanism in which HDL-C exerts its effects, suggesting a need for further research focused on new methods for reliable measurement.

Hypoxic training: Clinical benefits on cardiometabolic risk factors

“…However the amount of reduction beyond the effects of exercise had been inconsistent and numbers of controlled studies are few. HDL and LDL levels have been strongly associated with cardiovascular risk [41]. Even though no clear conclusions can be drawn on the beneficial effects of hypoxic training on HDL, it can be concluded that hypoxic training does not increase LDL levels, evident by none of the studies recording any significant increase in LDL levels.…”

Adipose tissue in obesity and obstructive sleep apnoea

“…Dyslipidaemia in obesity and OSA Obesity, MetS and type-II diabetes are characterised by a specific pattern of plasma lipids, called atherogenic dyslipidaemia [249], which is a powerful cardiovascular risk factor [250][251][252]. Atherogenic dyslipidaemia is also common in OSA, and a role for OSA in worsening dyslipidaemia is suggested by several experimental and clinical studies.…”

Predicting the risk of cardiovascular disease in HIV-infected patients: the Data collection on Adverse Effects of Anti-HIV Drugs Study

“…Most laboratory covariates were included, a priori, as continuous variables rather than as risk thresholds because of the expanding literature that now suggests there are no safe cut-offs for risk factors and that increases and decreases in covariates at any level are associated with increased or decreased cardiovascular risk [17][18][19][20] Furthermore, modern computing facilities and web-based tools reduce the need for simple computational algorithms or scoring systems [21].…”