Elevated cholesterol a red flag for heart failure in postmenopausal women

Postmenopausal women with a total cholesterol of at least 240 mg/dL and high-density lipoprotein cholesterol (HDL-C) of at least 100 mg/dL are at increased risk of heart failure (HF), according to a study.

The study included 1,307 Japanese women who were between 55 and 94 years of age. These women had no history of HF, and their baseline brain natriuretic peptide (BNP) levels were not more than 100 pg/mL.

Researchers conducted follow-ups every 2 years, where the presence of HF was determined. Women with BNP levels of ≥100 pg/mL received a diagnosis of heart failure. Cox proportional hazard models were used to estimate the risk of HF in relation to the women’s baseline total cholesterol, low-density lipoprotein cholesterol (LDL-C), and HDL-C levels.

Over an 8-year median follow-up, 153 participants received a diagnosis of HF. Multivariable analysis showed that the risk of HF was higher among women with total cholesterol of ≥240 mg/dL vs those with 160–199 mg/dL (hazard ratio [HR], 1.70, 95 percent confidence interval [CI], 1.04–2.77).

A risk increase was also observed for women with HDL-C of ≥100 mg/dL vs those with 50–59 mg/dL (HR, 2.70, 95 percent CI, 1.10–6.64).

The association between HF risk and elevated total cholesterol and HDL-C levels persisted despite controlling for baseline BNP.

No associations were seen for LDL-C.