High-density lipoprotein (HDL) cholesterol concentration (HDL-C) is an established atherosclerotic cardiovascular disease risk marker which quantifies how much total HDL cholesterol is in each HDL particle. Researchers from UT Southwestern investigated a less common HDL measure, HDL particle concentration (HDL-P), which measures the number of circulating HDL particles and its association with ischaemic stroke and myocardial infarction in parallel with HDL-C.
The study analysed individual data from over 15,000 people across four large population studies who were followed over an average of 8 to 12 years. People with the highest HDL-P levels had a 37% lower risk of heart attack and 34% lower risk of stroke. The risk reduction was stronger in women. On the other hand, HDL-C only predicted heart attack risk as well as in women, and was associated with stroke.
Neither HDL-P or HDL-C was associated with stroke or heart attack in the Black population suggesting minimal utility of HDL markers for risk prediction of either cardiovascular event in this ethnic group.
Why it matters: HDL-P may be a more consistent predictor of ischaemic stroke and myocardial infarction in the overall population unlike HDL-C, the conventional HDL measurement. Another important finding was that neither measurement was associated with myocardial infarction in the Black population. This study highlights the importance of refining risk markers for CVD that address all ethnicities to improve everyday primary care and cardiology.