Raising 'good cholesterol' not as effective as lowering 'bad cholesterol'

https://www.eurekalert.org/pub_releases/2016-10/acoc-rc102716.php

Public Release: 31-Oct-2016
Raising 'good cholesterol' not as effective as lowering 'bad cholesterol'
Low, very high HDL levels associated with death; HDL not independent heart disease risk factor
American College of Cardiology

Low and very high levels of HDL, or "good cholesterol" are associated with a higher risk of dying from heart disease, cancer and other causes, according to a study today in the Journal of the American College of Cardiology. The findings from the first of its kind study suggest that a low level of good cholesterol may not be a heart disease risk factor on its own and that raising HDL does not likely reduce a person's risk of heart disease.

To reduce risk of suffering a cardiac episode, many patients are treated to lower their LDL, or "bad cholesterol," with statins--a medication used to block the enzyme needed in the body to produce cholesterol. However, some people don't respond to this treatment, so researchers have been studying HDL and whether raising levels of "good cholesterol" could have the same benefits as lowering "bad cholesterol."

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However, even when adjusting for lifestyle factors, lower HDL levels were still associated with increased risk of both cardiovascular death and non-cardiovascular related death, such as death from cancer. Individuals with very high HDL levels had an increased risk of non-cardiovascular related death.

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Researchers said they are unsure why very high levels of HDL increased levels of non-cardiovascular related death, but other studies have suggested this could be related to increased alcohol intake.

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"The link between good cholesterol and heart disease is complex, but it seems certain that there is a connection between people with low good cholesterol levels and other well-known risk factors for heart disease such as poor diet and exercise habits and other medical conditions," said Dennis T. Ko, M.D., M.Sc., lead author of the study and an associate professor at the Institute for Clinical Evaluative Sciences in Toronto. "Focusing on raising HDL is likely not going to help these patients, but these findings show that one of the best interventions in treating and preventing heart disease continues to be lifestyle changes."

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