Higher Levels of 'Good' Cholesterol Linked to Increased Glaucoma Risk

 You'll have to ask your competent? doctor to PRECISELY SOLVE THIS CONUMDRUM FOR YOU!

CVD risk or glaucoma? Neither is good, your doctor better figure out an answer!

Higher Levels of 'Good' Cholesterol Linked to Increased Glaucoma Risk

Meanwhile, higher levels of LDL-C were associated with reduced risk

by Randy Dotinga, Contributing Writer, MedPage Today February 10, 2025

Key Takeaways

• Higher levels of high-density lipoprotein cholesterol were associated with an increased risk of glaucoma.
• High levels of low-density lipoprotein cholesterol, total cholesterol, and triglycerides were associated with a reduced risk of glaucoma.
• "Good" and "bad" cholesterol labels might need to be reassessed outside of cardiovascular disease.

Higher levels of high-density lipoprotein cholesterol (HDL-C) were associated with an increased risk of glaucoma, while high levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol, and triglycerides were associated with a reduced risk, a prospective study showed.

Among over 400,000 older U.K. Biobank participants, higher levels of HDL-C were associated with an increased risk of glaucoma (HR for 1-SD increase 1.05, 95% CI 1.02-1.08, P=0.001), while high levels of the other commonly used serum lipid measures were all linked to a reduced risk:

• LDL-C: HR 0.96, 95% CI 0.94-0.99, P=0.005
• Total cholesterol: HR 0.97, 95% CI 0.94-1.00, P=0.037
• Triglycerides: HR 0.96, 95% CI 0.94-0.99, P=0.008

"The causal relationship between blood lipids and glaucoma deserves further exploration, and it is recommended that age- and sex-specific effects be taken into account when assessing the relationship between lipids and glaucoma," wrote Zhenzhen Liu, MD, PhD, of Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science in China, and colleagues in the British Journal of Ophthalmologyopens in a new tab or window.

After adjusting for confounders, a 1-SD increment in HDL-C genetic risk was associated with a 5% greater hazard of glaucoma (HR 1.05, 95% CI 1.00-1.11, P=0.031). However, the polygenic risk score for LDL-C, total cholesterol, and triglycerides did not show a significant association with glaucoma.

Jeremy Sivak, PhD, of Krembil Research Institute at Toronto Western Hospital, told MedPage Today that "the results are surprising because the team found that so-called 'good' cholesterol is associated with greater risk of developing glaucoma, and 'bad' cholesterol is associated with lower risk. This result challenges some earlier studies that have reported the opposite association."

Sivak said that the concepts of "good" and "bad" cholesterol come from cardiovascular disease. "The role of these types of blood lipids in glaucoma is likely to be very different, and might be related to the regulation of fluid flow and pressure in the eye. One important take-away from this study is that these 'good' and 'bad' labels might need to be reassessed in the context of other diseases."

As for the findings about risk, the "differences are highly statistically significant, but the absolute differences in lipid levels are relatively small, revealed only by the large numbers of participants," Sivak noted. The data suggest that "there are variables in play that are still not accounted for and, as noted by the authors, correlations do not necessarily mean causation."

Sivak said one strength of the study is that it's prospective and follows the same population over time, while other research compared different patients at one point in time. "There seems to be good justification for further research in this area given the prospective study design and high statistical significance of the analyses," he added.

Victoria L. Tseng, MD, PhD, of the University of California Los Angeles Stein Eye Institute, noted that it is currently suspected that "vascular disease resulting from high cholesterol could compromise blood flow to the optic nerve and potentially be a risk factor to develop glaucoma or for it to get worse."

Is there a message for clinicians from this research? "I don't think we have sufficient evidence to recommend medication changes based on these findings," Tseng said. "Patients would benefit from continued chronic disease monitoring and management with their primary care providers to maximize systemic health in conjunction with their ocular conditions."

For this study, the researchers included 400,229 U.K. Biobank participants. Mean age was 56.4, 54% were women, and 94.9% were white. Of these patients, 26.8% had hypertension, 3.5% had diabetes, 3.3% had heart disease, and most (84.7%) had not used statins.

Over a mean 14.44 years of follow-up, 1.72% of patients were diagnosed with glaucoma. They were more likely to be older, non-white, and have a higher waist-to-hip ratio. They also had higher rates of diabetes (5.4%), hypertension (33.4%), and heart disease (4.8%).

The authors noted limitations to their study, including the almost entirely white patient population and the possibility that glaucoma cases were missed due to reliance on hospital records and self-assessments.

• 

  Randy Dotinga is a freelance medical and science journalist based in San Diego.

Disclosures

This study was supported by the Guangzhou Basic Research Program, City & University (Institute) Joint Funding Project, the National Natural Science Foundation of China of Guangdong Province, and the National Natural Science Foundation of China.

The study authors had no disclosures.

Sivak had no disclosures.

Tseng had no disclosures.

Primary Source

British Journal of Ophthalmology

Source Reference: opens in a new tab or windowMa Y, et al "Associations between serum lipids and glaucoma: a cohort study of 400 229 UK Biobank participants" Br J Ophthalmol 2025; DOI: 10.1136/bjo-2024-326062.

‘Good cholesterol’ and dementia: Researchers chart a correlation

My clinical reports don't seem to have my cholesterol levels.

‘Good cholesterol’ and dementia: Researchers chart a correlation

Despite its nickname as the “good cholesterol” because of its cardiovascular benefits, high-density lipoprotein (HDL) cholesterol was linked to as much as a 42 percent increased risk for dementia in older people with very high levels of HDL, according to research published in a Lancet journal, the Lancet Regional Health - Western Pacific.

Although HDL helps remove cholesterol from people’s arteries, the researchers wrote that, at very high levels, HDL’s structure and actions change, and it “may become deleterious to health” in various ways.

For more than six years, they tracked 18,668 study participants, all 65 or older and all physically and cognitively healthy at the start of the study. In those years, cognitive dementia was diagnosed in 850 participants (4.6 percent).
Those with very high HDL levels were more likely to have developed dementia than were those with more optimal HDL levels. For instance, the oldest participants with high HDL levels (those 75 or older) were 42 percent more likely to have developed dementia than those with normal HDL levels, and overall, anyone with high HDL levels had a 27 percent increased risk for dementia.

For adults, an HDL level of 40 mg/dL or higher is considered healthy for men and 50 mg/dL or higher is considered a healthy level for women. For the study, very high levels of HDL were considered to be 80 mg/dL or higher.

Related video: Risk factors for young-onset dementia (FOX 7 Austin)

Risk factors for young-onset dementia
The researchers wrote that the increased dementia risk from high HDL levels “appeared to be independent of traditional dementia risk factors, including physical activity level, alcohol intake, education, diabetes or smoking,” as well as genetic influences.

The researchers indicated that the reason for the link between high HDL levels and dementia risk was “unclear” and that further study would be needed to explain the connection.

This article is part of The Post’s “Big Number” series, which takes a brief look at the statistical aspect of health issues. Additional information and relevant research are available through the hyperlinks.

Researchers link high levels of ‘good’ cholesterol with excessive mortality

Be careful out there.
https://www.mdlinx.com/medical-student/top-medical-news/article/2017/08/28/7390102

University of Copenhagen Faculty of Health and Medical Sciences News

In striking contrast to the general perception, researchers from the University of Copenhagen have shown in a new study that people with extremely high levels of HDL – the ‘good’ cholesterol – in their blood have a more than 65 percent higher mortality rate than people with normal HDL levels. The researchers say the results should lead to a change in the way ‘good’ cholesterol is perceived.

The results of a new study from the University of Copenhagen seriously contradict the assumption that high levels of HDL in the blood are only a good thing. The researchers have shown that people with extremely high levels of good cholesterol have a higher mortality rate than people with normal levels. For men with extremely high levels, the mortality rate was 106 per cent higher than for the normal group. For women with extremely high levels, the mortality rate was 68 per cent higher.

“These results radically change the way we understand ‘good’ cholesterol. Doctors like myself have been used to congratulating patients who had a very high level of HDL in their blood. But we should no longer do so, as this study shows a dramatically higher mortality rate,” says Børge Nordestgaard, Professor at the Department of Clinical Medicine and one of the authors of the study.

The researchers analysed data for 116,000 subjects from the Copenhagen City Heart Study and the Copenhagen General Population Study, in combination with mortality data from the Danish Civil Registration System. They have followed the subjects for an average of 6 years, and based the study on just over 10,500 deaths.

The researchers were able to calculate the mortality rate based on these deaths and medical information on the subjects. The results showed that men with extremely high HDL levels in the blood had a 106 per cent higher mortality rate than men with a normal HDL level. Among women, those with extremely high levels of HDL had a 68 per cent higher mortality rate than the normal group. Men in the next group, with very high levels, also had a 36 per cent higher mortality rate.

0.4 per cent of the men and 0.3 per cent of the women covered by the study had an extremely high level of HDL in their blood, and a further 1.9 per cent of the men had a very high level.

The study also found excessive mortality for people with extremely low levels of HDL in the blood. The people with medium levels of HDL in the blood had the lowest mortality. For men, this level was 1.9 mmol/L. For women, it was 2.4 mmol/L.

Earlier US studies have shown similar correlations between good cholesterol and excessive mortality among specific population groups, but this is the first time excessive mortality has been shown in the general population. Professor Børge Nordestgaard, who also works as a consultant doctor at the Department of Clinical Biochemistry at Herlev and Gentofte Hospital, hopes the results can change our perception of HDL.

“It appears that we need to remove the focus from HDL as an important health indicator in research, at hospitals and at the general practitioner. These are the smallest lipoproteins in the blood, and perhaps we ought to examine some of the larger ones instead. For example, looking at blood levels of triglyceride and LDL, the ‘bad’ cholesterol, are probably better health indicators,” he notes.

The new study examines the statistical correlation between mortality and HDL levels. It therefore cannot explain why people with extremely high or low HDL levels have higher mortality.

The study titled, “Extreme high high–density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies,” was published in the European Heart Journal on 23 August 2017.