Elevated HDL-C May Not Benefit Postmenopausal Women

Higher HDL cholesterol in postmenopausal women may mask heart disease risk.

HealthDay News — Elevated high-density lipoprotein cholesterol (HDL-C) may not always be cardioprotective in postmenopausal women, according to a study published online July 19 in Arteriosclerosis, Thrombosis, and Vascular Biology.

Samar R. El Khoudary, Ph.D., M.P.H., from the University of Pittsburgh, and colleagues evaluated associations of HDL-C and ion-mobility HDL particles (HDL-P) with carotid intima-media thickness (cIMT) and carotid plaque in 1,380 women participating in the Multi-Ethnic Study of Atherosclerosis. Furthermore, the authors assessed interactions by age at and time since menopause.

The researchers found that when adjusting for each other, higher HDL-P was associated with lower cIMT (P = 0.001), but HDL-C was not. Higher HDL-C, but not HDL-P, was associated with greater risk of carotid plaque presence (P = 0.04). The association of large HDL-P with cIMT was significantly modified by time since menopause, but this was not the case for small HDL-P. Specifically, higher large HDL-P was associated with higher cIMT close to menopause, but with lower cIMT later in life. In women with later age at menopause who were >10 years postmenopausal, the proatherogenic association reported for HDL-C with carotid plaque was greatest.

“The results of our study are particularly interesting to both the public and clinicians because total HDL cholesterol is still used to predict cardiovascular disease risk,” Khoudary said in a statement. “High total HDL cholesterol in postmenopausal women could mask a significant heart disease risk that we still need to understand.”

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