In many population studies hyperinsulinemia has been shown to predict incidence of coronary heart disease, and the Finnish policemen Study has shown that this is the case up to twenty two years. In this slide (from Quebec) in which the predictive ability of high insulin concentrations for coronary heart disease was adjusted for the presence of the number of confounding variables including in this case HDL-cholesterol concentrations. It is seems clearly that hyperinsulinemia is a predictor for cardiovascular risk with in the presence of high or low HDL-cholesterol concentrations.