[A prospective study of serum high density lipoprotein cholesterol, cardiovascular and cerebrovascular risk in a Chinese muti-provinces cohort].

Objective: To evaluate the association between serum HDL-C and the risk of cardiovascular diseases (CHD) in subjects aged 35-64 years.

Methods: A prospective study was carried out in 11 provinces from 1992 to 2002. The association of baseline HDL-C level and cardiovascular disease occurrence was analyzed in 30384 subjects aged 35-64 years using Cox multivariate proportional hazards regression.

Results: (1) Compared with the group of HDL-C > or = 1.56 mmol/L, multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD), including CHD and ischemic stroke increased continuously with decreased HDL-C level. (2) HDL-C level had different impact on different types of CVD. Positive association was observed between HDL-C level and the risk of ischemic stroke, but the relationship between HDL-C level and the risk of hemorrhagic stroke was indefinite. Compared with the group with HDL-C > or = 1.56 mmol/L, the risk of CHD of the group with HDL-C < or =1.03 mmol/L increased by 45% (RR = 1.45, P<0.05) and that of ischemic stroke increased by 53% (RR = 1.53, P <0.01). (3) 6.4% of ICVD, 7.2% of the acute CHD and 7.3% of the acute stroke was attributable to low serum high density lipoprotein cholesterol.

Conclusions: Starting from HDL-C > or = 1.56 mmol/L, the risk of ICVD increases continuously with decreased HDL-C level. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce theoverall risk of CVD.