Cor Vasa 2026, 68(2):161-165 | DOI: 10.33678/cor.2025.100

Coronary Flow Velocity Reserve in Subjects with High HDL Cholesterol

Ozge Telci Caklili^a, Fatma Betul Ozcan^b, Ramazan Cakmak^c, Tugce Irgi^b, Oguz Konal^b, Mustafa Caliskan^b

^a Department of Endocrinology and Metabolism, Kocaeli City Hospital, Kocaeli, Turkey

^b Cardiology, Medeniyet University, Istanbul, Turkey

^c Department of Endocrinology and Metabolism, Medical Park Hospital, Istanbul, Turkey

Background: In recent years, it has been debated whether high HDL-C definitely provides cardiovascular protection. We compared coronary flow velocity reserve (CFVR) of subjects with normal HDL-C levels with subjects who have high HDL-C levels.

Methods and results: Subjects who were evaluated for angina with no pathological findings at the Cardiology Department of Istanbul Medeniyet University between 2012–2022 were screened and included to analysis if their HDL-C levels were ≥ 50 mg/dL. They were divided into two groups: (1) patients with HDL-C ≥ 70 mg/dL and (2) patients with HDL-C ≥ 50 and < 70 mg/ dL. Groups were compared in terms of CFVR.

Results: A total of 121 subjects (mean age: 37.60 ± 9.23; male n = 46, 38%) were included. There were 9 (7.4%) participants with HDL-C levels ≥ 70 mg/dL. When CFVR of participants with HDL-C ≥ 70 mg/dL was compared with participants with lower HDL (≥ 50 and < 70 mg/dL), CFVR was lower in the high HDL group (2.20 ± 0.52 vs. 2.65 ± 0.53, p = 0.007).

Conclusion: HDL-C levels ≥ 70 mg/dL may negatively impact coronary microcirculation.

Keywords: Coronary flow velocity reserve, Coronary microcirculation, High HDL-C

Received: July 11, 2025; Revised: July 11, 2025; Accepted: September 14, 2025; Prepublished online: June 2, 2012; Published: May 20, 2026  Show citation