European Primary Care Cardiovascular Society

Association between very high levels of HDL-c and increased risk of CV events

ESC 2018 - Munich

Sep. 4, 2018 - news

Elevated HDL-C is associated with adverse cardiovascular events

Presented at the ESC congress 2018 by: Marc Allard-Ratick (Atlanta, US)

Introduction and methods

Low levels of high density lipoprotein cholesterol (HDL-c) are associated with an increased cardiovascular (CV) risk, however, efforts to increase HDL-c did not lead to a decrease in CV risk. On the other hand, recent data indicate that there is a U-shaped association between HDL-c levels and adverse CV events and all-cause mortality.

In this study, 5,291 adults with CV disease, included in the Emory Cardiovascular Biobank, were followed-up for a median of 4.5 years (IQR: 1.8-6.9). Participants were divided into five groups based on their HDL-c levels:

The primary outcomes were all-cause mortality and CV death or non-fatal myocardial infarction (MI).

Main results


Very high levels of HDL-c were associated with increased risk of CV death.


After the presentation it was discussed that HDL is a very complex and multifunctional molecule that has not been fully understood yet. The possible mechanisms explaining such results may be genetic differentiation or dysfunctional HDL molecules, which are impaired as quantity increases. Very high HDL-c levels impact 1-5% of the general population, mostly females.

- Our reporting is based on the information provided at the ESC congress -