CANHEART: Is HDL cholesterol a cardiovascular specific risk factor?

Initial observational studies have identified high-density lipoprotein cholesterol (HDL-C) as an independent predictor of cardiovascular (CV) risk, even in patients on optimal statin therapy. However, the notion that higher HDL-C is better, has been seriously challenged by the results from several recent clinical and genetic trials. Data from the CANHEART study serve to clarify the relation between HDL-C and cause-specific mortality. Individuals with lower HDL-C levels were independently associated with higher risk of CV, cancer, and non-CV/non-cancer mortality compared with individuals in the reference ranges of HDL-C levels. Given the similarities in associations between HDL-C and CV as swell as non-CV outcomes, it is likely that HDL-C level serve as a marker of risk rather than a causal CV specific risk factor.