Study questions HDLs in predicting CVD risk

A new study in the Journal of the American College of Cardiology reported that HDL, typically regarded as “good cholesterol,” might not be as universally useful for determining people’s CVD risk as previously thought by researchers.

“It’s been well-accepted that low HDL cholesterol levels are detrimental, regardless of race,” said Nathalie Pamir, PhD, senior author of the study and an associate professor of medicine within the Knight Cardiovascular Institute at Oregon Health Science University in Portland. “Our research tested those assumptions.”

Pamir and her colleagues examined data from 23,901 U.S. adults who participated in the Reason for Geographic and Racial Differences in Stroke Study (REGARDS). The study participants were enrolled in REGARDS from 2003 to 2007, and researchers assessed data gathered during a 10- to 11-year period. Black and white study participants shared similar characteristics, such as age, cholesterol levels, and underlying risk factors for heart disease.

During this time period, 664 Black adults and 951 white adults experienced a heart attack or heart attack–related death. The study found that lower HDL cholesterol levels only predicted increased CVD risk for white adults, but not Black adults.

The research also expanded on results from other studies indicating that high HDL cholesterol levels are not always linked with lower CV events. This was true for both Black and white adults in the REGARDS analysis. The authors noted that in addition to supporting ongoing and future research with diverse populations, the findings indicate that CVD risk calculators using HDL cholesterol could lead to inaccurate predictions for Black adults.

“When it comes to risk factors for heart disease, they cannot be limited to one race or ethnicity,” said Pamir. “They need to apply to everyone.”