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ESC Congress 2026 Abstract

Extreme 'good' cholesterol not tied to excess deaths after matching

Men above 100 mg/dL had no higher death rate than matched men with average levels; the hazard ratio, a relative measure, was 0.98.

Paper by B A Ference, D L Wicks, A Hsieh, J J P Kastelein · University of Cambridge
Blood cells with dense versus sparse cholesterol particles sit beside equal groups of upright figures and matching liver shapes.
Cohort study of 429,892 UK Biobank participants, against participants with average HDL-CPopulations

Limit: Extreme levels above 100 mg/dL occurred in only 428 men and 3,295 women

Edited by Boris Djordjevic · AgingResearch.News

Paper
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An observational study analyzed 429,892 UK Biobank participants—198,510 men and 231,382 women—to examine HDL cholesterol, the cholesterol carried by high-density lipoprotein particles in blood. Participants with extremely high levels drank more alcohol and had more signs of alcohol-related illness.

Men with levels above 100 mg/dL initially had a higher rate of death from any cause than the reference group at the median cholesterol level for men. The hazard ratio, which compares event rates over time, was 2.87 before adjustment. After researchers matched participants for alcohol use and related illness, it was 0.98, indicating no higher death rate. Adjusting for alcohol consumption alone had not removed the association. Women with levels above 100 mg/dL had a lower risk of death from any cause.

Why it matters

Preventing cardiovascular disease is an important concern as people age. The analysis addresses concerns that medicines designed to raise this type of cholesterol might increase mortality.

Caveats

Because the main analysis was observational, matching cannot rule out unmeasured confounding. In addition, extreme levels above 100 mg/dL were rare, occurring in 428 men and 3,295 women.

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