For years, physicians have told patients that HDL (high-density lipoprotein cholesterol) helps protect them from cardiovascular disease (CVD). And the higher the number, the more the protection. HDL, often considered an independent predictor of heart disease, has been dubbed the "good" cholesterol, thanks to its protective effects. But a new study shows for the first time that HDL's protection depends on the levels of two other blood fats or lipids associated with heart disease. If these fats are not within normal ranges, even a high HDL may not be protective.
The new research analyzes nearly 25 years of data from the Framingham Heart Study's Offspring Cohort. It focuses on the roles HDL, LDL (low-density lipoprotein cholesterol) and triglycerides (TG) play in increasing or decreasing the risk of heart disease. The study, published online in Circulation: Cardiovascular Quality and Outcomes, followed 3,590 men and women without known cardiovascular disease between 1987 and 2011.
"There's no question that HDL does have a protective role, as we also confirm in the study, but HDL has been hyped-up," says senior author Michael Miller, MD, professor of cardiovascular medicine at the University of Maryland School of Medicine and preventive cardiologist at the University of Maryland Medical Center. "HDL really should be viewed as a third priority, with LDL on top and TG second."
The questions:
The method:
"Nobody has really looked at an isolated low and isolated high HDL, and whether or not other factors, such as triglycerides and LDL, make a difference in the risk of cardiovascular disease," says Dr. Miller.
The conclusions:
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