In the study, while low levels of HDL cholesterol predicted an increased risk of heart attack and related death in whites, it did not in blacks. Moreover, high levels of HDL-cholesterol do not appear to be protective: they were not associated with a reduced risk of cardiovascular disease in any of the groups.
“The goal was to understand this long-term association of HDL, which is referred to as beneficial cholesterol for people of all ethnicities. It is generally accepted that low levels of HDL cholesterol are harmful. Our research challenged these assumptions,” said Dr. Nathalie Pamir of Oregon Health & Science University in Portland.
To do this, the team evaluated data from 23,901 adults in the United States who participated in the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS). Previous studies that shaped perceptions of “good” cholesterol were mostly white adult study participants in the 1970s. In the current study, researchers examined how cholesterol levels in black and white middle-aged adults without heart disease related to future cardiovascular events. This suggests a slightly increased risk of cardiovascular disease in adults with elevated LDL cholesterol and triglyceride levels, which is consistent with previous research. However, it was observed for the first time that lower levels of HDL-cholesterol predicted an increased risk of cardiovascular disease only in white adults, and high levels of HDL-cholesterol did not necessarily protect against it.
What: DOI 10.1016/j.jacc.2022.09.027