28 November 2022

Bad "good" cholesterol

A study conducted with the support of the National Institutes of Health has shown that high-density lipoproteins (HDL), often called "good" cholesterol, may not be as effective in predicting the risk of cardiovascular diseases among adults of different racial and ethnic backgrounds. And if a low HDL level indicates an increased risk of myocardial infarction and associated death for representatives of the Caucasian race, then this correlation does not work for the Negroid race. In addition, higher HDL levels are not associated with a reduced risk of cardiovascular disease in any of the groups. These conclusions were made according to the population study REGARDS (Reasons for Geographic and Racial Differences in Stroke Study) with the participation of 23,901 adults in the United States.

Ideas about "good" cholesterol and heart health were obtained in the 1970s in studies with the predominant participation of white volunteers. The study participants were enrolled in REGARDS between 2003 and 2007, and the researchers analyzed information collected during 10-11 years of follow-up. Black and white participants had similar ages, cholesterol levels, and major risk factors for cardiovascular disease, including diabetes, high blood pressure, or smoking. During this time, 664 cases of myocardial infarction or death from cardiovascular diseases were recorded in black adults and 951 cases of such events in whites. Adults with elevated levels of "bad" cholesterol – LDL and triglycerides – had a moderately increased risk of cardiovascular disease, which is consistent with the results of previous studies.

However, it was found for the first time that lower HDL levels are associated with an increased risk of cardiovascular disease only in white adults. The results of other studies have also been confirmed, showing that high HDL levels are not always associated with a low frequency of cardiovascular events.


Race-specific association of HDL level with CHD risk (HR). Low HDL (low HDL-C) levels increased the risk only in white adults; high HDL (high HDL-C) levels did not reduce it in any of the races.

The authors urge to revise the algorithms for predicting the risk of cardiovascular diseases. In other words, achieving a high level of HDL does not mean that you can relax and not be afraid of a heart attack. They note that in this case, it is not so much the amount of HDL in the blood that is important, as its functionality, i.e. the ability to bind and remove excess cholesterol from the body. The group is working towards improving the functionality of HDL: a search is underway for compounds associated with the transport of cholesterol.

In addition, a deeper study of the epidemiology of lipid metabolism is needed, especially in terms of how race can alter or mediate metabolic processes.

Article by Zakai et al. The Race-Dependent Association of High-Density Lipoprotein Cholesterol Levels With Incident Coronary Artery Disease is published in the Journal of the American College of Cardiology.

Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru based on the materials of the National Heart, Lung, and Blood Institute NIH: Study challenges "good" cholesterol's role in universally predicting heart disease risk.

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