A prospective study of serum high density lipoprotein cholesterol, cardiovascular and cardiovascular risk in a Chinese muti-provinces cohort / 中华内科杂志

ABSTRACT

Objective To evaluate the association between serum HDL-C and the risk of cardiovascular diseases(CHD) in subjects aged 35-64 years. Methods A prospective study was carried out in 11 provinces from 1992 to 2002. The association of baseline HDL-C level and cardiovascular disease occurrence was analyzed in 30384 subjects aged 35-64 years using Cox multivariate proportional hazards regression. Results (1) Compared with the group of HDL-C≥1.56 mmol/L, multivariate-adjusted relative risk of ischemic cardiovascular disease(ICVD), including CHD and ischemic stroke increased continuously with decreased HDL-C level. (2)HDL-C level had different impact on different types of CVD.Positive association was observed between HDL-C level and the risk of ischemic stroke,but the relationship between HDL-C level and the risk of hemorrhagic stroke was indefinite. Compared with the group with HDL-C≥1.56 mmol/L,the risk of CHD of the group with HDL-C≤1.03 mmol/L increased by 45%(RR=1.45,P＜0.05)and that of ischemic stroke increased by 53%(RR=1.53,P＜0.01).(3)6.4% of ICVD,7.2% of the acute CHD and 7.3% of the acute stroke was attributable to low serum high density lipoprotein cholesterol. Conclusions Starting from HDL-C≥1.56 mmol/L, the risk of ICVD increasescontinuously with decreased HDL-C level. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce theoverall risk of CVD.