Background: Recently, there are controversial findings on protective effect of high-density lipoprotein cholesterol (HDL-C) against coronary heart disease (CHD) in some population.
Objective: We aim to determine the effect of HDL-C on CHD in premenopausal and postmenopausal women.
Methods: Between February 1999 and August 2001, 3778 women aged 30 to 74 y, free of clinical cardiovascular diseases, were recruited and followed up to March 2010. HDL-C and other CHD risk factors were measured at baseline. Using multivariable Cox proportional hazard model, the adjusted hazard ratio was calculated.
Results: During a median follow-up of 9.6 y, a total of 228 new CHD events occurred. In postmenopausal women, the adjusted hazard ratio for each standard deviation increase in HDL-C was 0.76 (95% confidence interval, 0.63-0.92). Among premenopausal women, a time varying model was fitted; the adjusted hazard ratio for each standard deviation increase of HDL-C among 30-year-old women was 2.67 (95% confidence interval, 0.98-7.29) but decreased by 5% for each year increase of age.
Conclusions: Different effects of HDL-C in premenopausal and postmenopausal women were identified. During premenopausal period, the hazard of CHD increased by any increase of HDL-C level, but the amount of this increment gradually decreased over time, whereas during postmenopausal period, the hazard of CHD was inversely associated with HDL-C level.
Keywords: Coronary heart disease; Cox proportional hazard model; High-density lipoprotein cholesterol; Menopause; Time varying model.
Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.