High HDL levels are but one component of a healthy heart

BY DR. KOMOROFF Universal Uclick
Wednesday, December 19, 2012
12/19/12 at 2:27 AM


Dear Doctor K: For years my doctor has been telling me about the benefits of high levels of HDL cholesterol. Now I read that high HDL may not protect against heart disease after all. Is "good" cholesterol still good for you?

Dear Reader: The HDL cholesterol story demonstrates once again that even the most persuasive theories about what should make us healthy need to be put to the test.

It has been solidly established that people who have high levels of LDL (bad) cholesterol have a higher risk of developing heart disease. And it has been solidly established that treatments that lower LDL cholesterol reduce the risk of developing heart disease.

It also has been solidly established that people with HDL levels above 60 milligrams per deciliter (mg/dL) tend to have a lower risk for heart disease. Because HDL cholesterol removes fat from the plaques in arteries, that observation made sense.

Doctors and scientists assumed that boosting HDL with medication would lower cardiac risk even more. There are several drugs that have been around for 30 years that modestly raise levels of HDL. These drugs were tested in people with heart disease. They did lower the risk of new heart problems, but it wasn't clear if they achieved that benefit by lowering HDL cholesterol or through some other effect.

Then several different types of drugs were developed that could dramatically raise HDL levels. Before such drugs were approved by the Food and Drug Administration, however, the agency required that studies involving large numbers of people be conducted to prove the value of the drugs. Over the past five years these drugs have proved very disappointing. In some cases, they have increased the risk.

Many lifestyle changes raise HDL cholesterol and indisputably reduce your risk of heart disease: regular exercise, healthy weight, avoiding trans fats, quitting smoking and moderate use of alcohol.



Write Dr. K at www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106

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