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24-10-2011 | Cardiometabolic | Article

HDL predicts CHD independent of physical fitness


Free abstract

MedWire News: High-density lipoprotein (HDL) cholesterol is a strong predictor for long-term coronary heart disease (CHD) risk independent of physical fitness (PF), research suggests.

"Our results indicate that HDL levels should be taken into account when estimating risk of CHD and CVD [cardiovascular disease] regardless of PF level," remark Per Skretteberg (Oslo University Hospital, Norway) and colleagues.

Writing in the journal Atherosclerosis the authors explain that HDL cholesterol and PF have both been shown to predict CVD, particularly CHD.

The team therefore tested the hypothesis that PF influences the long-term prognostic impact of HDL on risk for CHD, as well as CHD- and CVD-related, and all-cause death, among 1357 healthy middle-aged (44-69 years) men.

PF was measured using bicycle exercise tests, and participants were followed-up for up to 28 years.

The researchers found that the risk for CHD, fatal CHD and CVD, and all-cause death was 43%, 44%, 36%, and 20% lower, respectively, among individuals in the highest HDL cholesterol quartile (1.72-3.30 mmol/L [66.41-127.41 mg/dL]) compared with those in the lowest quartile (0.81-1.30 mmol/L [31.27-50.19 mg/dL]).

Adjustments for PF or changes in PF measured over 8.6 years did not change these results, report Skretteberg et al, except for all-cause death, which was not significantly different between HDL quartiles.

The team found no significant interaction between HDL cholesterol and PF.

Commenting on their findings, the researchers say: "Our results indicate that the largest difference in risk of CHD, CHD death, and CVD death is between HDL levels of 1.31-1.51 mmol/L [50.58-58.30 mg/dL] and 1.52-1.71 mmol/L [58.69-66.02 mg/dL]."

They add that men with HDL cholesterol in the range of 1.52-1.71 mmol/L and 1.72-3.30 mmol/L appear to have similar risk, indicating that an HDL increase above 1.50 mmol/L is "not necessarily associated with further risk reduction."

They conclude: "Our findings support the notion that HDL and PF are associated to some degree, but shows that HDL's predictive ability on CHD and CVD remains similar at all levels of PF."

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By Nikki Withers