Gender difference in the level of high-density lipoprotein cholesterol in elderly Japanese patients with coronary artery disease

Objective High-density lipoprotein cholesterol (HDL-C) levels are known to be reduced in the metabolic syndrome, but the HDL-C profile of elderly patients with coronary artery disease (CAD) has not been well characterized. This study investigated the gender difference of HDL-C levels in elderly Japanese patients with CAD. Methods Serum lipid data were analyzed retrospectively to assess sex-related differences of the lipid profile, and to evaluate the effects of pharmacotherapy or physical exercise on hyperlipidemia. Patients A total of 163 elderly (65 years) outpatients with CAD (128 men aged 70.6 +/- 5.2 years and 35 women aged 74.1 +/- 6.0 years [mean +/- SD]) were investigated. Results The mean total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels were similar in men and women, while the mean HDL-C level was significantly higher in women than men (58.3 +/- 18.1 vs. 50.3 +/- 13.5 mg/dL; p=0.0064). The HDL-C level was not significantly influenced by oral lipid-lowering therapy or regular exercise in either sex. However, women without lipid-lowering therapy had significantly higher HDL-C levels than men with (p=0.0312) or without (p=0.0338) lipid-lowering therapy, while women performing regular exercise had significantly higher HDL-C levels than men with (p=0.0047) or without (p <= 0.001) regular exercise. Conclusion Elderly women with CAD have higher HDL-C levels relative to their postmenopausal state than those of men with CAD. Low HDL-C levels, unlike in men, may not be a major risk factor for CAD in elderly women.