HDL cholesterol and CV risk association not affected by statins
MedWire News: Statin therapy does not alter associations between high-density lipoprotein (HDL) cholesterol levels and cardiovascular (CV) outcomes, results of a large meta-analysis suggest.
"Statin-treated patients are subject to the same magnitude of risk associated with lower levels of HDL cholesterol as similar control participants," say Haseeb Jafri, from Tufts Medical Center in Massachusetts, USA, and colleagues.
"Low levels of HDL cholesterol remain significantly and independently associated with increased risk, despite statin treatment," they add.
The team examined the associations between HDL levels and CV outcomes in nearly 71,000 statin-treated patients, and compared this with a similar cohort of control participants.
They found that there was a significant inverse association between HDL cholesterol levels and risk for myocardial infarction (MI) in statin-treated and control participants, and this relationship persisted after adjustment for on-treatment low-density lipoprotein (LDL) cholesterol level, age, and proportion of patients with hypertension, diabetes mellitus, and tobacco use.
In addition, the association showed no significant differences between the two groups; for every 0.26 mmol/l (10.0 mg/dl) decrease in HDL cholesterol there were on average 8.3 and 7.1 more MIs per 1000 person-years among the statin-treated and control groups, respectively.
The researchers say that this suggests that the effect of HDL cholesterol on MI risk is not altered by statin therapy.
Furthermore, similar findings were observed when the team examined other CV disease outcomes.
"The persistent CV risk in statin-treated patients may be partly explained by low levels of HDL cholesterol or other CV disease risk factors that are associated with low levels of HDL cholesterol," Jafri and team explain in the Annals of Internal Medicine.
They conclude: "The findings underscore the importance of recognizing the risk associated with low levels of HDL cholesterol, even in statin-treated patients, and highlight the need for additional clinical investigation that targets levels of HDL cholesterol in this context."
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By Nikki Withers