HDL, or “good” cholesterol, may not affect heart health, medical study claims

High-density lipoprotein (HDL), once referred to by medical experts as “good cholesterol,” is being re-examined after a new study questioned the benefits of this type of cholesterol across racial lines.

Researchers at the Knight Cardiovascular Institute at Oregon Health & Science University analyzed 23,901 medical profiles from the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS) and compared risk factors for cardiovascular events occurring in middle-aged black and white patients.

The study was funded by the National Institutes of Health (NIH), a medical research agency under the US Department of Health and Human Services, and was published in the Journal of the American College of Cardiology on Monday, November 21.

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Of the thousands of REGARDS participants analyzed, the researchers narrowed their findings to patients who enrolled in the study between 2003 and 2007, and then followed the patients’ medical records for 10 to 11 years.

Black and white study participants reportedly had similar cholesterol levels and underlying heart disease risk factors, including diabetes, high blood pressure and smoking.

Various fruits and vegetables lower cholesterol levels.

Various fruits and vegetables lower cholesterol levels.
(iStock)

Over the decade, researchers found that 664 black patients and 951 white patients had a heart attack or heart attack-related death.

“It has been well accepted that low levels of HDL cholesterol are harmful, regardless of race. Our research tested these assumptions,” lead study author Nathalie Pamir wrote in a statement, according to the NIH.

“The goal was to understand this long-established link that identifies HDL as beneficial cholesterol, and if it applies across all ethnicities,” added Pamir, who is an associate professor of medicine at Oregon Health & Science University, Portland.

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High-density lipoprotein has reportedly been rated favorably because it has been shown to absorb cholesterol from the blood and transport it back to the liver, according to the US Centers for Disease Control and Prevention (CDC).

The liver is said to flush cholesterol out of the body, which can reduce the risk of heart disease and stroke if HDL cholesterol levels are high.

Too much cholesterol in the blood can lead to cardiovascular events such as heart attack and stroke.

Too much cholesterol in the blood can lead to cardiovascular events such as heart attack and stroke.
(iStock)

According to the CDC, low-density lipoprotein (LDL), also known as “bad cholesterol,” makes up most of the body’s cholesterol.

A high level of LDL cholesterol is associated with an increased risk of heart disease and stroke.

“When your body has too much LDL cholesterol, LDL cholesterol can build up on the walls of your blood vessels,” the CDC wrote in an online explanation of cholesterol. “This buildup is called ‘plaque.’

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An analysis of REGARDS data in the new study confirmed that high levels of LDL cholesterol and triglycerides (neutral fats) led to a “modestly increased risk of cardiovascular disease,” according to the NIH.

Low levels of HDL cholesterol were found to increase the risk of cardiovascular disease in white patients, but the same was not true for black patients, according to the study.

According to various studies, exercise has been shown to improve cholesterol levels.

According to various studies, exercise has been shown to improve cholesterol levels.
(iStock)

The study also found that high levels of HDL cholesterol are not always associated with a lower likelihood of cardiovascular events — regardless of race.

The study authors concluded that cardiovascular disease risk calculators that use HDL cholesterol values ​​could return an inaccurate prediction in black patients.

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“HDL cholesterol has long been an enigmatic risk factor for cardiovascular disease,” Sean Coady, deputy chief of epidemiology at the National Heart, Lung, and Blood Institute’s Division of Cardiovascular Sciences, wrote in a statement.

“The findings suggest that a deeper dive into the epidemiology of lipid metabolism is warranted,” Coady continued. “Especially when it comes to how race can modify or mediate those relationships.”

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Fully the published study can be found on the Journal of the American College of Cardiology website at jacc.org.

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