More About Your HDL or Good Cholesterol

Cholesterolis a waxy , pale yellow fat, travels through the bloodstream in small, protein covered particles called Lipo proteins that mix easily with blood. We need cholesterol to form cell membranes, make hormones and synthesize vitamin D among other things.

Your lipid panel includes your total cholesterol, your triglycerides, your HDL cholesterol or good cholesterol and bad cholesterol or LDL cholesterol. HDL has long been referred to as good cholesterol based on observational studies, dating back decades showing that people with high HDL levels are less likely to develop cardiovascular disease.

Recently many cardiologists believe that HDL may be more of a bystander rather than a “good guy” that helped to reduce heart disease risk. High HDL level are closely linked to behaves like healthy eating pattern and getting regular exercise, not smoking and maintaining an ideal body weight. Heredity is often associated with Low HDL.

Researchers have also discovered that the way HDL functions and its role in the body are more complex than previously believed. The analogy that often used to describe HDL is a garbage truck because it picks up extra cholesterol or garbage from the bloodstream and arteries and then transport it to the liver where it is recycled or disposed off.

This was the rational behind developing experimental drugs that raised HDL levels dramatically, as much as 60 to 100%. During the last several years, clinical trials tested five of these experimental drugs known as CEPT inhibitors in people with low HDL level.

These drugs reliably raised HDL levels, but they did not achieve the most important goal that is preventing heart disease,stroke and other complications from clogged arteries. This was disappointing. The thinking was, maybe it wasn’t the number of garbage trucks that matters but how good they were at picking up trash. That is, maybe the drugs increase the wrong kind of HDL cholesterol.

HDL comes in different sizes and shapes. Some types are spherical and some are doughnut shaped . Some types of HDL are great at plucking excess cholesterol from LDL and arterial wall, a process called reverse cholesterol transport, while some are not capable of doing that.

Study done in more than 18,000 patients and published in NEW ENGLAND JOURNAL OF MEDICINE last year showed that those patients who received intravenous injection of experimental drug failed to prevent heart attack, stroke or death from cardiovascular disease even though it reliably increased the HDL level. .

But this finding shouldn’t discourage us from focusing on the factors we can control.-namely, making sure that your LDL cholesterol is below 100 or even lower if you have heart disease.

That is true even if you have a high HDL level, which shouldn’t be considered overly reassuring or a reason to ignore an elevated LDL cholesterol ideally, your HDL cholesterol should be more than 40 if you are a man or more than 50 if you are a woman. As of now, there is no drug which reliably increases the HDL and decreases the Cardiovascular risk.

Niacin was used in the past which reliably increased HDL, but failed to decrease the Cardiovascular risk. Hence,Niacin is no longer used

Dr Keshava Aithal ಅಂಕ 8 Double 0