The study suggests that HDL, or “good” cholesterol, is less beneficial than previously thought, especially for black adults
High-density lipoprotein, or HDL, cholesterol — often called “good” cholesterol — may not be as useful in predicting heart disease risk and protecting against it as previously thought, according to new research funded by the National Institutes of Health.
A study in the 1970s found that high levels of HDL cholesterol were associated with a low risk of coronary heart disease, a link that has since been widely accepted and used in heart disease risk assessment. However, only white Americans were included in that study.
Now, Research published Monday in the Journal of the American College of Cardiology found that low levels of HDL cholesterol were associated with a higher risk of heart attack among white adults, but the same was not true among black adults. Also, higher levels of HDL cholesterol were not found to reduce the risk of cardiovascular disease for any group.
“It is well accepted that low levels of HDL cholesterol are harmful, regardless of race. Our research tested those assumptions,” said Nathalie Pamir, senior study author and associate professor of medicine at the Knight Cardiovascular Institute at Oregon Health & Science University, Portland, in news. “This could mean that in the future, doctors won’t be patting us on the back for higher HDL cholesterol levels.”
The researchers used data from thousands of people who were included in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Participants were at least 45 years old when they joined the program between 2003 and 2007, and their health was analyzed for an average of 10 years.
The researchers found that high levels of low-density lipoprotein (LDL) cholesterol and triglycerides “modestly” predicted heart disease risk among both black and white adults.
But they suggest more work is needed to understand what drives racial differences in the relationship between HDL and heart disease risk.
Meanwhile, current clinical assessments of heart disease risk “may misclassify risk in black adults, potentially impeding optimal cardiovascular disease prevention and management programs for this group,” they wrote.
CNN Medical Correspondent Dr. Tara Narula, associate director of the Lenox Hill Women’s Heart Program, said the study “highlights the very important need for more racial and ethnic research and that there is no one-size-fits-all approach. Additionally, this research underscores the continuing need for education that high HDL levels are not free and that the focus must be on controlling elevated LDL and other known markers of increased cardiovascular risk.”