HDL, or “good” cholesterol, may not affect heart health, a medical study suggests
High-density lipoprotein (HDL), which medical experts call “good cholesterol,” is being re-examined after a new study questioned its benefits. type of cholesterol across racial lines.
Researchers from the Knight Cardiovascular Institute at the University of Oregon analyzed 23,901 medical profiles from the Reasons for Geographic and Racial Disparities in Stroke (REGARDS) study 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 within the US Department of Health and Human Services, and was published in the Journal of the American College of Cardiology on Monday, November 21.
Of the thousands of REGARDS participants analyzed, the researchers narrowed their findings to patients enrolled in the study between 2003 and 2007, and then tracked the patients’ health records for 10 to 11 years.
Participants in black and white studies reportedly had similar cholesterol levels and underlying risk factors for heart disease, including diabetes, high blood pressure, and smoking.
Over a decade-long period, researchers found that 664 black patients and 951 white patients experienced a heart attack or heart attack-related death.
“It is well accepted that low levels of HDL cholesterol are harmful, regardless of race. Our study tested those assumptions,” wrote Nathalie Pamir, senior author of the study, according to the NIH.
“The goal was to understand this long-established link that marks HDL as beneficial cholesterol, and if this is true across ethnic groups,” added Pamir, who is an associate professor of medicine at Oregon Health & Science University, Portland.
According to the US Centers for Disease Control and Prevention (CDC), high-density lipoprotein is said to be viewed favorably because it has been shown to absorb cholesterol from the blood and return it to the liver.
The liver supposedly removes cholesterol from the body, which can reduce a person’s chances heart disease and stroke if there are high levels of HDL cholesterol.
According to the CDC, low-density lipoprotein (LDL), also known as “bad cholesterol,” makes up most of the cholesterol in the body.
High levels of LDL cholesterol are 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 cholesterol explanation. “This deposit is called ‘plaque’.”
Analysis of data from the new REGARDS study confirmed that high levels of LDL cholesterol and triglycerides (neutral fats) result in a “moderately increased risk of cardiovascular disease,” according to the NIH.
Low levels of HDL cholesterol were found to increase the risk of cardiovascular disease for white patients, but the same was not true for black patients, according to the study.
At the same time, the study found that high levels of HDL cholesterol were not always associated with a lower chance of cardiovascular events—regardless of race.
This is the conclusion of the authors of the study risk of cardiovascular disease calculators using readings of HDL cholesterol levels could give an inaccurate prediction for black patients.
“HDL cholesterol has long been an enigmatic risk factor for cardiovascular disease,” Sean Coady, deputy chief of epidemiology in the National Heart, Lung, and Blood Institute’s Division of Cardiovascular Sciences, wrote in a statement.
“The findings suggest a deeper dive into epidemiology lipid metabolism is warranted,” Coady continued. “Especially in terms of how race can modify or mediate these relationships.”
Fully the published study can be found on the Journal of the American College of Cardiology website at jacc.org.
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