Background and aims Statins generally increase high-density lipoprotein cholesterol (HDL-C), but not in all patients. This retrospective study was designed to 1) assess the characteristics and the different response patterns of lipoprotein level after statin therapy, comparing the patients with decreased HDL-C level after statin therapy (poor response group) and the patients with preserved or increased HDL-C level after statin therapy (favorable response group), 2) check up long term trends of lipoprotein profiles. Methods Total 516 patients (256 males and 260 females) were enrolled. All patients had received one kind of statins for more than a year. Serum level of total cholesterol (TC), triglycerides (TG), HDL-C, low-density lipoprotein cholesterol (LDL-C) before the initiation of statin therapy, two to six months and 1 year after statin therapy, were collected. Data of body mass index (BMI), coexistence of diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD) and prescribed statin and its dose were included in analysis. Results Average age was 63.3 years and mean BMI was 25.4. Major patients were with CAD(96%). Prevalence of DM was 37%, HTN was 71%. The prevalences were not different between groups(poor response group vs. favorable response group). Poor response group showed more decrease of TC (p<0.001) and LDL-C (p<0.001) and increase of TG (p<0.001). After 1 year , 70.2% of poor response group, HDL-C level remained decreased. When analyzed by prescribed statins, there was no relation between the kinds of statins and bad HDL-C response. Conclusions Serum HDL-C level increased with statin therapy in some patients, but decreased in the others. The risk of HDL-C decrease with statin therapy coexists with large reduction of LDL-C level. The trend did not changed for a year, so HDL-C raising therapy should be considered with statin therapy, especially in the patients with poor HDL-C responses and high risk group.